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Condition: Disability
Therapy: Thrombolytic Therapy

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Total 183 results found since Jan 2013.

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

Prehospital Thrombolysis for Stroke An Idea Whose Golden Hour Has Arrived
Soon after thrombolytic therapy was established as a therapy for ischemic stroke, our colleague Anthony Furlan, MD, famously circulated a cartoon of a computed tomographic (CT) scanner visible through the back doors of an ambulance, where a happy stroke physician had hung a bottle dripping tissue plasminogen activator (tPA) into the scanned patient’s arm. Because the time interval from stroke onset to initiation of thrombolysis after ischemic stroke is inversely related to the probability of disability-free recovery, prehospital initiation of thrombolytic therapy seemed a compelling and logical ambition, if one could rul...
Source: JAMA Neurology - November 17, 2014 Category: Neurology 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

World Stroke Organization Global Stroke Services Guidelines and Action Plan
Every two seconds, someone across the globe suffers a symptomatic stroke. ‘Silent’ cerebrovascular disease insidiously contributes to worldwide disability by causing cognitive impairment in the elderly. The risk of cerebrovascular disease is disproportionately higher in low to middle income countries where there may be barriers to stroke care. The last two decades have seen a major transformation in the stroke field with the emergence of evidence‐based approaches to stroke prevention, acute stroke management, and stroke recovery. The current challenge lies in implementing these interventions, particularly in regions ...
Source: International Journal of Stroke - September 23, 2014 Category: Neurology Authors: Patrice Lindsay, Karen L. Furie, Stephen M. Davis, Geoffrey A. Donnan, Bo Norrving Tags: Guidelines Source Type: research

Update in the Management of Acute Ischemic Stroke
Acute ischemic stroke is the fourth leading cause of death and the leading cause of disability in the United States. Stroke is a medical emergency. The development of stroke systems of care has changed the way practitioners view and treat this devastating disease. Ample evidence has shown that patients presenting early and receiving intravenous thrombolytic therapy have the best chance for significant improvement in functional outcome, particularly if they are transported to specialized stroke centers. Early detection and management of medical and neurologic complications is key at preventing further brain damage in patien...
Source: Critical Care Clinics - August 4, 2014 Category: Intensive Care Authors: Nelson J. Maldonado, Syed O. Kazmi, Jose Ignacio Suarez Source Type: research

Thrombolysis ImPlementation in Stroke (TIPS): evaluating the effectiveness of a strategy to increase the adoption of best evidence practice - protocol for a cluster randomised controlled trial in acute stroke care
DiscussionTIPS will trial a comprehensive, multi-component and multidisciplinary collaborative approach to improving thrombolysis rates at multiple sites. The trial has the potential to identify methods for optimal care which can be implemented for stroke patients during the acute phase. Study findings will include barriers and solutions to effective thrombolysis implementation and trial outcomes will be published whether significant or not.Trial registration: Australian New Zealand Clinical Trials Registry: ACTRN12613000939796
Source: Implementation Science - March 25, 2014 Category: Health Management Authors: Christine PaulChristopher LeviCatherine D¿EsteMark ParsonsChristopher BladinRichard LindleyJohn AttiaFrans HenskensErin LalorMark LongworthSandy MiddletonAnnika RyanErin KerrRobert Sanson-Fisher Source Type: research

Role of Preexisting Disability in Patients Treated With Intravenous Thrombolysis for Ischemic Stroke Clinical Sciences
Conclusions— Prestroke disability does not seem to independently increase the risk of symptomatic intracranial hemorrhage after thrombolysis. Despite higher mortality, 1 in 3 previously disabled patients may return to his/her prestroke mRS. Therefore, they should not be routinely excluded from thrombolytic therapy.
Source: Stroke - February 24, 2014 Category: Neurology Authors: Karlinski, M., Kobayashi, A., Czlonkowska, A., Mikulik, R., Vaclavik, D., Brozman, M., Svigelj, V., Csiba, L., Fekete, K., Korv, J., Demarin, V., Vilionskis, A., Jatuzis, D., Krespi, Y., Ahmed, N., Wahlgren, N., for the Safe Implementation of Treatments i Tags: Thrombolysis Clinical Sciences Source Type: research

Routine serum C‐reactive protein and stroke outcome after intravenous thrombolysis
ConclusionsAccording to our findings, elevated routine serum CRP measured within 24 h after admission does not seem to independently affect the outcome in patients receiving intravenous thrombolysis for stroke. However, further studies of blood samples taken directly before the treatment are needed.
Source: Acta Neurologica Scandinavica - February 20, 2014 Category: Neurology Authors: M. Karlinski, J. Bembenek, K. Grabska, A. Kobayashi, A. Baranowska, T. Litwin, A. Czlonkowska Tags: Original Article Source Type: research

Stroke and Stroke Mimics: A Pattern-Based Approach
“Stroke” is a general term that describes a clinical event characterized by a sudden onset of an acute neurologic deficit. Arterial ischemia comprises 80% of all strokes and is a leading cause of death and disability in the United States. Since the advent of thrombolytic therapy for ischemic stroke, rapid and accurate diagnosis has become essential.
Source: Seminars in Roentgenology - November 6, 2013 Category: Radiology Authors: Daniel J. Boulter, Pamela W. Schaefer Source Type: research

Simultaneous thrombosis of 2 vascular territories: is thrombolytic therapy a better option?
We have read with great interest the article by Akyuz and colleagues in the American Journal of Emergency Medicine and congratulate them for their observation. Their case exemplifies the concurrent occurrence of ST-segment elevation myocardial infarction (STEMI) and posterior circulation stroke that was eventually managed with thrombolytic therapy. Simultaneous thrombosis of 2 distant vascular territories is a rare and complicated clinical scenario. In these instances, there is usually an underlying cause linking both thrombotic events rather than being a mere coincidence. We have previously described the myocardial infarc...
Source: The American Journal of Emergency Medicine - July 1, 2013 Category: Emergency Medicine Authors: Hesham R. Omar, Devanand Mangar, Enrico M. Camporesi Tags: Correspondence 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

RCT: Endovascular treatment for acute ischaemic stroke
Source: NEJM Area: News A study, published in New England Journal of Medicine, compares the clinical efficacy of endovascular treatment with systemic intravenous thrombolytic therapy in patients with ischaemic stroke.   The study randomly assigned 362 patients with acute ischemic stroke, within 4.5 hours after onset, to endovascular therapy (intra-arterial thrombolysis with recombinant tissue plasminogen activator [t-PA], mechanical clot disruption or retrieval, or a combination of these approaches) (181 patients) or intravenous t-PA (181 patients). Treatments were to be given as soon as possible after randomisat...
Source: NeLM - News - February 8, 2013 Category: Drugs & Pharmacology Source Type: news

Thrombolytic Agents for Acute Ischaemic Stroke Treatment: the Past, Present and Future.
Abstract Despite advances in the diagnosis and treatment of acute ischaemic stroke in the past two decades, stroke has remained the third cause of mortality and the single leading cause of disability worldwide. The immediate goal of acute ischaemic stroke therapy is to salvage the ischaemic penumbra through recanalisation of the occluded cerebral blood vessel. This is currently achieved through thrombolytics, which are pharmacological agents that can break up a clot blocking the flow of blood. To date, the only approved thrombolytic for treatment of acute ischaemic stroke is recombinant tissue plasminogen activato...
Source: CNS and Neurological Disorders Drug Targets - February 4, 2013 Category: Drugs & Pharmacology Authors: Balami JS, Chen R, Sutherland BA, Buchan AM Tags: CNS Neurol Disord Drug Targets Source Type: research