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Condition: Thrombosis
Management: National Institutes of Health (NIH)
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Total 90 results found since Jan 2013.
Intravenous Thrombolysis with Recombinant Tissue Plasminogen Activator in a Stroke Patient Treated with Rivaroxaban
As limited amounts of data are available regarding thrombolytic therapy for patients taking novel oral anticoagulants, thrombolytic therapy is not recommended in such cases. Here, we report an acute stroke patient taking rivaroxaban who received intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA). An 80-year-old man with a history of nonvalvular atrial fibrillation, who had been receiving 10 mg of rivaroxaban showed abrupt onset of aphasia and right hemiparesis. National Institutes of Health Stroke Scale score was 10.
Source: Journal of Stroke and Cerebrovascular Diseases - September 30, 2014 Category: Neurology Authors: Hideyuki Ishihara, Hiroaki Torii, Hirochika Imoto, Fumiaki Oka, Hirokazu Sadahiro, Michiyasu Suzuki Tags: Case Report Source Type: research
Effects of Batroxobin with Continuous Transcranial Doppler Monitoring in Patients with Acute Cerebral Stroke: A Randomized Controlled Trial
Our objective was to determine whether continuous transcranial Doppler (TCD) monitoring could safely enhance the efficacy of batroxobin, a thrombin‐like enzyme extracted from Bothrops atrox moojeni venom, in the treatment for acute cerebral stroke beyond the thrombolytic time window. Ninety patients suffering an acute cerebral stroke were recruited into the study within 12 hours after the onset of symptoms. Patients were randomized to receive batroxobin with (target group) or without 1 hour of continuous TCD monitoring (control group). Clinical evaluation of stroke was based on the National Institutes of Health Stroke ...
Source: Echocardiography - March 1, 2014 Category: Cardiology Authors: He Yitao, Ma Kefu, Tang Bingshan, Fu Xuejun, Zhan Ying, Cai Zhili, Jiang Xin, Yi Guo Tags: Original Investigation Source Type: research
Predictive Factors for Early Clinical Improvement after Intra-arterial Thrombolytic Therapy in Acute Ischemic Stroke
This study aimed to identify clinical and radiological variables that are predictive of early improvement (EI) after IAT in acute ischemic stroke.Methods: This single-center retrospective cohort study included 141 consecutive patients who underwent IAT for terminal internal carotid and/or middle cerebral artery (MCA) occlusions. EI was defined as a National Institutes of Health Stroke Scale (NIHSS) score less than 3 or NIHSS score improvement of 8 points or more within 72 hours of IAT. The EI and non-EI groups were compared in terms of clinical and radiological findings before and after IAT.Results: Forty-nine patients sh...
Source: Journal of Stroke and Cerebrovascular Diseases - February 14, 2014 Category: Neurology Authors: Hye Seon Jeong, Hyun-Jo Kwon, Chang Woo Kang, Hee-Jung Song, Hyeon Song Koh, Sang Min Park, Jung Geol Lim, Ji Eun Shin, Suk Hoon Lee, Jei Kim Tags: Original Articles Source Type: research
The Usefulness of the Kurashiki Prehospital Stroke Scale in Identifying Thrombolytic Candidates in Acute Ischemic Stroke
Patients with acute ischemic stroke should be rapidly triaged to a stroke center with the highest quality of stroke care to assess the severity of a stroke within an appropriate time. However, the important information about the severity of a stroke cannot be provided by widely used prehospital stroke scales. The Kurashiki prehospital stroke scale (KPSS) was constructed using four metrics, including level of consciousness, disturbance of consciousness, motor weakness, and language, with total scores ranging from 0 to 13. The maximum of 13 points represented the most severe symptoms. The KPSS was developed in 2008 to assess...
Source: The Journal of Emergency Medicine - January 23, 2014 Category: Emergency Medicine Authors: J.S. You, H.S. Chung, S.P. Chung, J. Jang, H.S. Lee Source Type: research
Gynecologic Surgery in the Obese Patient
Obesity is a chronic multifactorial disease that presents serious health risks due to excessive fat accumulation in adipose tissue . Determinants such as genetics, psychosocial factors, the environment, poor diet, and physical inactivity all have a role in its development. Obesity was defined in 1998 by the National Institutes of Health clinical guidelines as body mass index (BMI) ≥30 . Obese individuals are at higher risk for many comorbid conditions and for overall mortality than are non-obese individuals. Some of these conditions include type 2 diabetes mellitus, hypertension, coronary artery disease, stroke, obstruc...
Source: The Journal of Minimally Invasive Gynecology - January 23, 2014 Category: OBGYN Authors: Karen Cooper, Tommaso Falcone Tags: Editorial Source Type: research
Leukocytes May Have 2 Opposing Effects in Intravenous rtPA Treatment for Ischemic Stroke
We hypothesized that leukocytes have 2 opposing effects on patients with ischemic stroke treated with recombinant tissue plasminogen activator (rtPA). Patients with ischemic stroke treated with rtPA were divided into 2 groups using the peripheral leukocyte count: high leukocyte group (HLG) and low leukocyte group (LLG) and were evaluated with the National Institutes of Health stroke scale (NIHSS) during the first 24 hours. We defined significant improvement (SI) as NIHSS improving by more than 50% from the baseline, and deterioration following improvement (DFI) as the achievement of SI within 24 hours but its subsequent lo...
Source: Clinical and Applied Thrombosis/Hemostasis - December 12, 2013 Category: Hematology Authors: Nomura, E., Naka, H., Wakabayashi, S., Kajikawa, H., Matsumoto, M. Tags: Original Articles Source Type: research
Tissue plasminogen activator for transient ischemic attack: the case for “off-label” use of thrombolytics
We describe an illustrative case of a patient with recurring middle cerebral artery (MCA) ischemia, where our risk benefit analysis led to the administration of thrombolytic therapy despite the patient’s score of 0 on the National Institute of Health Stroke Score (NIHSS).
Source: The American Journal of Emergency Medicine - November 6, 2013 Category: Emergency Medicine Authors: Richard M. Sobel, Daniel T. Wu, Kristina Hester, Kim Anda Tags: Correspondence Source Type: research
Questionable reversal of anticoagulation in the therapeutic management of cerebral haemorrhage associated with vitamin K antagonists.
Abstract
Reversal of anticoagulation is recommended to correct the international normalised ratio (INR) for patients with intracranial haemorrhage (ICH) associated with vitamin K antagonists (VKA). However, the validity of such treatment is debated. We sought to identify, prospectively, the prognostic effect of VKA-ICH treatment in a cohort of patients (n=71; median age 78 years, range 20-89; 57% males). Data collated were: baseline characteristics, treatments, baseline and post-treatment INR, haematoma volume, and haematoma enlargement. Treatment effects and prognostic factor assessment were in relation to mortal...
Source: Thrombosis and Haemostasis - September 12, 2013 Category: Hematology Authors: Alonso de Leciñana M, Huertas N, Egido JA, Muriel A, García A, Ruiz-Ares G, Díez-Tejedor E, Fuentes B Tags: Thromb Haemost Source Type: research
Drugs to be offered to women at high risk of breast cancer
The National Institute of Health and Care Excellence (NICE) has today released updated guidelines on the care of women who are at increased risk of breast cancer due to their family history. One of the main changes to the original guidance from 2004 is that NICE now recommends drug treatment with tamoxifen or raloxifene to reduce risk of breast cancer in a specific group of women who are at high risk of breast cancer and have not had the disease.
They say that these treatments could help prevent breast cancer in about 488,000 women aged 35 years and older.
The updated guideline has also made changes to the recommende...
Source: NHS News Feed - June 25, 2013 Category: Consumer Health News Tags: Cancer Medical practice QA articles Source Type: news
Carotid Artery Free-Floating Thrombus Caused by Paradoxical Embolization From Greater Saphenous Vein Ascending Thrombophlebitis
We report a case of a young woman without cardiovascular risk factors who was admitted to our emergency department with listlessness and altered mental status. The clinical examination revealed right lower limb swelling. Magnetic resonance imaging and contrast-enhanced computed tomographic scans revealed a free floating thrombus of the left internal carotid artery (ICA) with a large bilateral frontal ischemic lesion. The diagnosis of a medium-sized PFO with moderate right-to-left contrast shunting was made after transesophageal echocardiography. No other cardiac sources for embolization were detected, while an ascending th...
Source: Annals of Vascular Surgery - April 28, 2013 Category: Surgery Authors: Luigi Irace, Roberto Gabrielli, Maria Sofia Rosati, Maria Fabrizia Giannoni, Anna Castiglione, Antonella Laurito, Bruno Gossetti Tags: Case Report Abstracts Source Type: research
Prediction of Thrombolytic Therapy after Stroke-Bypass Transportation: The Maria Prehospital Stroke Scale Score
There is no prehospital stratification tool specifically for predicting thrombolytic therapy after transportation. We developed a new prehospital scale named the Maria Prehospital Stroke Scale (MPSS) by modifying the Cincinnati Prehospital Stroke Scale. Our objective is to evaluate its utility in a citywide bypass transportation protocol for intravenous (IV) tissue plasminogen activator (tPA). In the MPSS, facial droop, arm drift, and speech disturbance are tested by emergency medical technicians (EMTs). Facial droop is graded as normal (0) or abnormal (1), and the other 2 items are graded in 3 levels as normal (0), not se...
Source: Journal of Stroke and Cerebrovascular Diseases - March 13, 2013 Category: Neurology Authors: Yasuhiro Hasegawa, Naoshi Sasaki, Koji Yamada, Hajime Ono, Junichiro Kumai, Kotaro Tsumura, Kazunari Suzuki, Hiroyuki Nozaki, Hitoshi Nakayama, Ichiro Takumi, Hirofumi Nikaido, Tuyoshi Katabami, Toshihiro Ueda, Shinichi Suzuki, Ryosei Iwai, Hiroshi Takaha Tags: Original Articles Source Type: research
Dabigatran etexilate: management in acute ischemic stroke.
Abstract
A 54-year-old man treated with dabigatran experienced new onset of a stroke with a score of 9 on the National Institutes of Health Stroke Scale. Administration of recombinant tissue plasminogen activator (rtPA) was not recommended because of the dabigatran therapy. Angiography showed occlusion of the left middle cerebral artery by an embolic thrombus. Suction thrombectomy achieved flow through the inferior division of the artery. Computed tomography of the head showed possible intracranial hemorrhage, and dabigatran reversal was attempted with prothrombin complex concentrate and recombinant factor VIIa. C...
Source: American Journal of Critical Care - March 1, 2013 Category: Nursing Authors: Javedani PP, Horowitz BZ, Clark WM, Lutsep HL Tags: Am J Crit Care Source Type: research
Predictors of In-hospital Mortality and the Risk of Symptomatic Intracerebral Hemorrhage after Thrombolytic Therapy with Recombinant Tissue Plasminogen Activator in Acute Ischemic Stroke
This study aimed to determine the independent predictors of in-hospital mortality (IHM) and the risk of sICH after rt-PA therapy. A total of 1007 patients (mean age, 72 ± 12 years; 52% women; mean National Institutes of Health Stroke Scale [NIHSS] score, 11.6 ± 5.6) with AIS treated with rt-PA were enrolled in this study during a 42-month period beginning in November 2007. Univariate and multivariate regression analyses were performed to estimate the predictors of IHM. Eighty-three of the 1007 patients (8.2%) died during hospitalization (mean duration of hospitalization, 10 ± 1.8 days). Logistic regression estimated the...
Source: Journal of Stroke and Cerebrovascular Diseases - May 14, 2012 Category: Neurology Authors: Mohamed Al-Khaled, Christine Matthis, Jürgen Eggers Tags: Original Articles Source Type: research
Are Racial Disparities in Stroke Care Still Prevalent in Certified Stroke Centers?
Racial differences in stroke risk and risk factor prevalence are well established. The present study explored racial differences in the delivery of care to patients with acute stroke between Joint Commission (JC)-certified hospitals and noncertified hospitals. A retrospective chart review was conducted in patients sustaining ischemic stroke admitted to 5 JC-certified centers and 5 noncertified hospitals. Demographic data, risk factors, utilization of acute stroke therapies, and compliance with core measures were recorded. Racial disparities were investigated in the entire group as well as for JC-certified and noncertified ...
Source: Journal of Stroke and Cerebrovascular Diseases - November 14, 2011 Category: Neurology Authors: Pratik Bhattacharya, Flicia Mada, Leeza Salowich-Palm, Sabrina Hinton, Scott Millis, Sam R. Watson, Seemant Chaturvedi, Kumar Rajamani Tags: Original Articles Source Type: research
Tissue Plasminogen Activator Thrombolytic Therapy for Acute Ischemic Stroke in 4 Hospital Groups in Japan
In October 2005 in Japan, the recombinant tissue plasminogen activator (tPA) alteplase was approved for patients with acute ischemic stroke within 3 hours of onset at a dose of 0.6 mg/kg. The present study was undertaken to assess the safety and efficacy of alteplase in Japan. Between October 2005 and December 2009, a total of 114 consecutive patients admitted to 4 hospitals received intravenous tPA within 3 hours of stroke onset. Clinical backgrounds and outcomes were investigated. The patients were divided into 2 chronological groups: an early group, comprising 45 patients treated between October 2005 and December 2007,...
Source: Journal of Stroke and Cerebrovascular Diseases - October 4, 2011 Category: Neurology Authors: Syoichiro Kono, Kentaro Deguchi, Nobutoshi Morimoto, Tomoko Kurata, Shoko Deguchi, Tohru Yamashita, Yoshio Ikeda, Tohru Matsuura, Hisashi Narai, Nobuhiko Omori, Yasuhiro Manabe, Taijyun Yunoki, Yoshiki Takao, Sanami Kawata, Kenichi Kashihara, Koji Abe Tags: Original Articles Source Type: research
