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Therapy: Thrombolytic Therapy

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Time is Brain - Preclinical Emergency Care for Acute Ischemic Stroke
Anasthesiol Intensivmed Notfallmed Schmerzther. 2021 Dec;56(11-12):746-759. doi: 10.1055/a-1330-5239. Epub 2021 Nov 24.ABSTRACTStroke is one of the most common neurological emergencies and requires rapid detection and treatment (time is brain). There is still insufficient knowledge about stroke warning signs. It is therefore of crucial importance that trained personnel in the preclinical setting recognize the relevant warning symptoms and collect the necessary information to quickly refer the patient to the appropriate additional care structure. For this purpose, training of the emergency medical services (EMS) and the cor...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - November 25, 2021 Category: Intensive Care Authors: Leona M öller Lars Timmermann Anja Gerstner Source Type: research

J147 Reduces tPA-Induced Brain Hemorrhage in Acute Experimental Stroke in Rats
ConclusionOur results demonstrate that J147 treatment alone exerts cerebral cytoprotective effects in a suture model of acute ischemic stroke, while in an embolic stroke model co-administration of J147 with tPA reduces delayed tPA-induced intracerebral hemorrhage and confers cerebroprotection. These findings suggest that J147-tPA combination therapy could be a promising approach to improving the treatment of ischemic stroke.
Source: Frontiers in Neurology - March 2, 2022 Category: Neurology Source Type: research

Clinical Outcomes of Extracranial Carotid Artery-Related Stroke Eligible for Mechanical Reperfusion on Top of Per-Guidelines Thrombolytic Therapy: Analysis from a 6-Month Consecutive Patient Sample in 2 Centers
CONCLUSIONS In a real-life AIS-CA setting, the referral rate of EMR-eligible patients for EMR was low, and the treatment rate was even lower. AIS-CA revascularization was delivered predominantly in stroke thrombectomy-capable cardioangiology centers, resulting in overwhelmingly superior patient outcome. Large vessel occlusion stroke referral and management pathways should involve centers with proximal-protected CAS expertise. AIS-CA, irrespective of any thrombolysis administration, is a hyperacute cerebral emergency and EMR-eligible patients should be immediately referred for mechanical reperfusion.PMID:36451526 | DOI:10.12659/MSM.938549
Source: Medical Science Monitor - December 1, 2022 Category: Research Authors: Karolina Dzierwa Magdalena Knapik Łukasz Tekieli Adam Mazurek Ma łgorzata Urbańczyk-Zawadzka Artur Klecha Tomasz Kowalczyk Teresa Ko źmik Łukasz Wiewiórka Pawe ł Banyś Ewa W ęglarz Justyna Stefaniak Rafa ł T Nizankowski Iris Q Grunwald Piotr Mus 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

Using Routine Data for Quality Assessment in NeuroNet Telestroke Care
Background: Systematic clinical trials are often unavailable to evaluate and optimize operational telestroke networks. In a complementary approach, readily available routine clinical data were analyzed in this study to evaluate the effect of a telestroke network over a 4-year period.Methods: Routine clinical data from the HELIOS hospital information system were compared before and after implementation of the NeuroNet concept, including neurologic acute stroke teleconsultations, standard operating procedures, and peer review quality management in 3 hospital cohorts: 5 comprehensive stroke centers, 5 NeuroNet hospitals, and ...
Source: Journal of Stroke and Cerebrovascular Diseases - February 24, 2012 Category: Neurology Authors: Stephan Theiss, Franziska Günzel, Anna Storm, Patrick Hausn, Stefan Isenmann, Joachim Klisch, Guntram W. Ickenstein, NeuroNet network Tags: Original Articles Source Type: research

Factors influencing functional recovery in patients with acute ischemic stroke
Conclusion: The best predictor for physical functional recovery was receiving thrombolytic therapy. In addition, acute stroke care services demonstrated to have an association with psychological function.
Source: Collegian - November 26, 2012 Category: Nursing Authors: Sarunya Koositamongkol, Siriorn Sindhu, Wanpen Pinyopasakul, Yongchai Nilanont, Richard W. Redman Tags: Regular papers Source Type: research

Identifying Barriers in Acute Stroke Therapy in Argentina. ARENAS Registry (P2.014)
CONCLUSIONS: Only 47% of patients were admitted to an Intensive Care Unit, rt-PA was underused and initial evaluation was not performed by a neurologist in most of cases. The gap between clinical practice guidelines and real world is wide in Argentina and interventions to improve acute stroke care are mandatory.Disclosure: Dr. Atallah has nothing to disclose. Dr. Fustinoni has nothing to disclose. Dr. Zurru has nothing to disclose. Dr. Beigelman has nothing to disclose. Dr. Cirio has nothing to disclose. Dr. Ameriso has nothing to disclose. Dr. Burry has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Atallah, A., Fustinoni, O., Zurru, M., Beigelman, R., Cirio, J., Ameriso, S., Burry, G. Tags: Cerebrovascular Disease and Interventional Neurology I Source Type: research

HAT Score Outperforms 7 Other Hemorrhagic Transformation Scores in Ischemic Stroke Patients Treated with Thrombolysis (P3.109)
Conclusions: HAT score yielded the highest odds ratio among the 4 scores that accurately predicted sICH in our independent dataset. HAT score also had low computational complexity compared to other scores. Our results demonstrate the potential utility of the HAT score as a predictor of adverse clinical outcome for acute ischemic stroke patients undergoing IV thrombolytic therapy.Disclosure: Dr. Asuzu has nothing to disclose. Dr. Nystrom has nothing to disclose. Dr. Halliday has nothing to disclose. Dr. Wira has nothing to disclose. Dr. Greer has nothing to disclose. Dr. Schindler has nothing to disclose. Dr. Sheth has rece...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Asuzu, D., Nystrom, K., Halliday, J., Wira, C., Greer, D., Schindler, J., Sheth, K. Tags: Cerebrovascular Disease and Interventional Neurology: t-PA Source Type: research

Poor Awareness of Stroke—A Hospital-Based Study from South India: An Urgent Need For Awareness Programs
Background: Stroke treatment has reached a new benchmark with thrombolytic therapy. However, India has witnessed a tremendous increase in morbidity and mortality of stroke over the past few decades. The prime deciding factor is initiation of treatment within the time window, which requires early recognition of stroke symptoms. We wished to analyze the lacunae in the stroke knowledge in our population. This hospital-based study assessed awareness of the public regarding stroke.Methods: Two trained medical students interviewed accompanying relatives using a structured questionnaire. Data were analyzed using Statistical Packa...
Source: Journal of Stroke and Cerebrovascular Diseases - August 11, 2014 Category: Neurology Authors: Bindu Menon, Jatla J. Swaroop, Haripuram K.R. Deepika, Jyothi Conjeevaram, K. Munisusmitha Tags: Original Articles Source Type: research

Patient Factors Do Not Predict Thrombolysis in Stroke Mimics (P6.031)
CONCLUSIONS: Physician decision to administer thrombolysis in stroke mimic patients without clear contraindication is not associated with patient demographic or clinical factors. Our study is limited by its retrospective nature and small sample size, however continued data collection is in process.Disclosure: Dr. Gildersleeve has nothing to disclose. Dr. Pandurengan has nothing to disclose. Dr. Gonzales has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Gildersleeve, K., Pandurengan, R., Gonzales, N. Tags: Neurotherapeutics Source Type: research

Validation of Stroke and Thrombolytic Therapy in Korean National Health Insurance Claim Data.
CONCLUSIONS: Discharge with hemorrhagic stroke and use of thrombolytic therapy were identified with high reliability in administrative discharge data. A substantial level of agreement was also obtained for IS, despite variation between the algorithms and data sets. PMID: 26365022 [PubMed - as supplied by publisher]
Source: Journal of Clinical Neurology - September 15, 2015 Category: Neurology Tags: J Clin Neurol Source Type: research

Post t-PA transfer to hub improves outcome of moderate to severe ischemic stroke patients
Conclusions Patients with moderate to severe ischemic strokes who were treated with t-PA in a telestroke network may potentially benefit from expert care at a primary stroke center.
Source: Journal of Telemedicine and Telecare - September 18, 2015 Category: Information Technology Authors: Yaghi, S., Harik, S. I., Hinduja, A., Bianchi, N., Johnson, D. M., Keyrouz, S. G. Tags: RESEARCH/Original Articles Source Type: research

Intravenous thrombolytic therapy for ischemic stroke via telemedicine compared with bedside treatment in an experienced stroke unit
Conclusions This study demonstrates that the telestroke system, Virtuall, is as safe and effective in initiating rt-PA treatment as bedside evaluation in an experienced stroke unit, despite a longer intra-hospital time.
Source: European Research in Telemedicine - December 1, 2015 Category: Information Technology Source Type: research

Factors Influencing Quality of Life Six Months after a First-Ever Ischemic Stroke: Focus on Thrombolyzed Patients
Conclusion: In this study, most patients were treated with thrombolysis, and QoL results resembled those of earlier studies on patients without thrombolysis. Despite good physical recovery, the patients reported impairments in QoL. QoL assessments can give clinicians a more holistic picture of stroke recovery from the patient's perspective.Folia Phoniatr Logop 2016;68:86-91
Source: Folia Phoniatrica et Logopaedica - September 29, 2016 Category: Speech Therapy 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