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Ten-Year Evaluation of the TOYOTA Prehospital Stroke Scale for Tissue Plasminogen Activator Intravenous Therapy in the Real World
Conclusions: The TOPSPIN is a simple prehospital stroke scale that includes an assessment of atrial fibrillation. Detection of atrial fibrillation in the prehospital stage may point to a higher probability of ischemic stroke.Cerebrovasc Dis 2018;46:184 –192
Source: Cerebrovascular Diseases - November 1, 2018 Category: Neurology Source Type: research

Cardiac Output Monitoring Managing Intravenous Therapy (COMMIT) to Treat Emergency Department Patients with Sepsis
The objectives of this study were to determine if a fluid responsiveness protocol would decrease progression of organ dysfunction, and a fluid responsiveness protocol would facilitate a more aggressive resuscitation. Methods: Prospective, 10-center, randomized interventional trial. Inclusion criteria: suspected sepsis and lactate 2.0 to 4.0 mmol/L. Exclusion criteria (abbreviated): systolic blood pressure more than 90 mmHg, and contraindication to aggressive fluid resuscitation. Intervention: fluid responsiveness protocol using Non-Invasive Cardiac Output Monitor (NICOM) to assess for fluid responsiveness (>10% increa...
Source: Shock - July 19, 2016 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

Chelation Remains A Hopeful Heart Therapy
Maybe you know someone who has suffered a heart attack. You're concerned about their well-being, particularly if they're diabetic or suffered a large heart attack. You want to make sure that absolutely everything that can help this loved one stay healthy and alive is discussed with their doctors. Odds are very high, however, that there's one promising therapy the doctor won't tell them about: chelation therapy. Chelation therapy was designed decades ago to trap and remove serious environmental toxins like arsenic. While using it, some practitioners noted improvements in symptoms of heart disease, and chelation began to ...
Source: Healthy Living - The Huffington Post - July 1, 2016 Category: Consumer Health News Source Type: news

Mp13: important role of prothrombin time (pt) and partial thromboplastin time (ptt) in predicting tpa-related hemorrhagic transformation
Conclusions Higher PT/PTT level within 72 hr of IV tPA is early marker of tPA-induced HT. Whether these routine labs have value in symptomatic hemorrhage will require further study in a larger cohort. But this proof-of-concept study suggests that tPA efficacy can potentially be followed in real time. The development of a reliable blood test would be of clinical utility to gauge thrombolytic efficacy in real time to guide and triage adjunct treatments. Abstract MP13 Figure 1
Source: Journal of Investigative Medicine - February 25, 2016 Category: Research Authors: Deng, W., Wickham, T., McMullin, D., Feeney, K., Buonanno, F., Lo, E., Ning, M. Tags: Moderated Poster, 11:45 PM - 1:05 PM, Wednesday, April 13, 2016 Source Type: research

Advances in endovascular treatment of acute ischaemic stroke
Abstract Over the past decade, there have been rapid advancements in ischaemic stroke reperfusion treatments. However, clear clinical benefit is yet to be shown in large clinical trials. In this review, the major studies in different types of endovascular treatments including intra‐arterial thrombolysis, aspiration devices, mechanical clot retrievers and the new stent retrievers are discussed. First‐generation mechanical thrombectomy devices such as the MERCI Retriever (Stryker, Kalamazoo, MI, USA) and Penumbra aspiration device (Penumbra Inc., Alameda, CA, USA) demonstrated safety and higher rates of recanalisation in...
Source: Internal Medicine Journal - July 28, 2015 Category: Internal Medicine Authors: H. Asadi, R. Dowling, B. Yan, S. Wong, P. Mitchell Tags: Review Source Type: research

Comparative efficacy of different acute reperfusion therapies for acute ischemic stroke: a comprehensive benefit–risk analysis of clinical trials
ConclusionIntravenous thrombolysis (IVT) with TNK and sonothrombolysis have the higher BRR among investigational reperfusion therapies. The combination of sonothrombolysis with IV administration of TNK appears a potentially promising therapeutic option deserving further investigation. Intravenous (IV) thrombolysis with tenecteplase (TNK) and sonothrombolysis appear to have the higher benefit‐to‐risk ratios among investigational reperfusion therapies. The combination of sonothrombolysis with IV administration of TNK could have a potentially promising therapeutic option that deserves further investigation.
Source: Brain and Behavior - September 10, 2014 Category: Neurology Authors: Georgios Tsivgoulis, John Alleman, Aristeidis H. Katsanos, Andrew D. Barreto, Martin Kohrmann, Peter D. Schellinger, Carlos A Molina, Andrei V. Alexandrov Tags: Review Source Type: research