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Mobile Stroke Units: A Device in Search of an Indication
If you've been to any regional or national EMS conference in the last two years, you've seen these mobile stroke units. They are beautiful large ambulances with the latest and greatest in modern technology including mobile CT scanners. Often, the name of a hospital is blazoned on the side. There is usually a staff member present to tell you how great these will be for your community. But are they? Where's the science? What's the cost? These are important questions that should be asked and answered before these devices are deployed on a widespread basis. Although still somewhat controversial, therapies are now available to ...
Source: JEMS Patient Care - January 12, 2017 Category: Emergency Medicine Authors: Bryan Bledsoe, DO, FACEP, FAEMS Tags: Patient Care Source Type: news

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

Reassuring Results for tPA on Long-term Mortality in Stroke Reassuring Results for tPA on Long-term Mortality in Stroke
Three-year results from the IST-3 trial show a nonsignificant reduction in mortality for stroke patients receiving thrombolytic therapy. Medscape Medical News (Source: Medscape Neurology and Neurosurgery Headlines)
Source: Medscape Neurology and Neurosurgery Headlines - May 19, 2016 Category: Neurology Tags: Neurology & Neurosurgery News Source Type: news

Hospitals Overestimate Their Ability to Deliver Timely tPA Hospitals Overestimate Their Ability to Deliver Timely tPA
Less than a third of hospitals accurately estimated how often they provide thrombolytic therapy within 60 minutes of stroke patient arrival. Medscape Medical News (Source: Medscape Neurology and Neurosurgery Headlines)
Source: Medscape Neurology and Neurosurgery Headlines - August 6, 2015 Category: Neurology Tags: Neurology & Neurosurgery News Source Type: news

Ways To Improve Door-to-Needle Times in Stroke Treatment
WASHINGTON, DC — A streamlined emergency care service and a low-cost, tablet-based mobile telestroke system are two examples of shortening the time it takes for acute ischemic stroke patients to receive thrombolytic therapy that were presented at the annual meeting of the American Academy of Neurology. (Source: Caring for the Ages)
Source: Caring for the Ages - August 1, 2015 Category: Health Management Authors: Elizabeth Mechcatie Source Type: news

Bleeding Risk With Systemic Thrombolytic Therapy for PEBleeding Risk With Systemic Thrombolytic Therapy for PE
How often does bleeding occur in patients receiving thrombolytic therapy for PE? Can you minimize the risk? Therapeutic Advances in Drug Safety (Source: Medscape Today Headlines)
Source: Medscape Today Headlines - May 22, 2015 Category: Consumer Health News Tags: Emergency Medicine Journal Article Source Type: news

Risk Communication in Hyperacute Stroke ThrombolysisRisk Communication in Hyperacute Stroke Thrombolysis
A new study identifies variations among clinicians in the risk communication of thrombolytic therapy for hyperacute stroke. What strategies could better help patients understand the risks? Emergency Medicine Journal (Source: Medscape Today Headlines)
Source: Medscape Today Headlines - May 21, 2015 Category: Consumer Health News Tags: Emergency Medicine Journal Article Source Type: news

Stroke Rounds: Kidney Disease Not Always a Barrier to tPA (CME/CE)
(MedPage Today) -- CKD need not prohibit thrombolytic therapy in otherwise eligible stroke patients. (Source: MedPage Today Cardiovascular)
Source: MedPage Today Cardiovascular - September 25, 2014 Category: Cardiology Source Type: news

Stroke Rounds: Guidelines on rtPA Brain Bleeds Lack Data (CME/CE)
(MedPage Today) -- Current guidelines for treating brain bleeds caused by thrombolytic therapy for strokes are based on empirical evidence alone and widely used treatments may not be adequate, researchers suggested. (Source: MedPage Today Cardiovascular)
Source: MedPage Today Cardiovascular - July 29, 2014 Category: Cardiology Source Type: news

Mixed Results for Thrombolysis in Pulmonary Embolism (FREE)
By Larry Husten Edited by David G. Fairchild, MD, MPH Among patients with acute pulmonary embolism (PE), thrombolytic therapy reduces mortality relative to standard anticoagulation, but at the cost of increased bleeding, a JAMA meta-analysis finds. Researchers analyzed … (Source: Physician's First Watch current issue)
Source: Physician's First Watch current issue - June 18, 2014 Category: Primary Care Source Type: news

Mixed Results for Thrombolysis in Pulmonary Embolism
The role of thrombolytic therapy for the treatment of pulmonary embolism has been unclear, as it has been difficult to measure the precise balance between enhanced clot-dissolving efficacy and greater bleeding risk produced by thrombolysis when compared with conventional anticoagulation. (Source: Forbes.com Healthcare News)
Source: Forbes.com Healthcare News - June 17, 2014 Category: Pharmaceuticals Authors: Larry Husten Source Type: news

Thrombolysis Aids PE Survival, but Ups Bleeding Risk (CME/CE)
(MedPage Today) -- Thrombolytic therapy nearly halved mortality in patients with pulmonary embolism (PE), but at the cost of a higher risk of major bleeding, especially in the elderly, a meta-analysis found. (Source: MedPage Today Cardiovascular)
Source: MedPage Today Cardiovascular - June 17, 2014 Category: Cardiology Source Type: news

Effectiveness of Early Stroke Thrombolysis Confirmed in Community-Based Study (FREE)
By Amy Orciari Herman Edited by David G. Fairchild, MD, MPH, and André Sofair, MD, MPH The effectiveness of early thrombolytic therapy after acute stroke observed in randomized trials persists in everyday clinical practice, according to a large, … (Source: Physician's First Watch current issue)
Source: Physician's First Watch current issue - June 3, 2014 Category: Primary Care Source Type: news

Stroke Rounds: Score Predicts Response to Clot Busters
(MedPage Today) -- Higher-risk patients according to a simple risk score incorporating age and stroke severity appear to derive the most benefit from thrombolytic therapy for an acute ischemic stroke, an observational study showed. (Source: MedPage Today Cardiovascular)
Source: MedPage Today Cardiovascular - May 6, 2014 Category: Cardiology Source Type: news

Stroke Rounds: Speeding tPA Use, Assuming Consent (CME/CE)
(MedPage Today) -- This week, JAMA released a theme issue on neurology, which contained several studies related to stroke. They included two studies evaluating ways to improve the speed with which thrombolytic therapy is administered and one looking at whether consent to thrombolytic therapy can be assumed. (Source: MedPage Today Cardiovascular)
Source: MedPage Today Cardiovascular - April 24, 2014 Category: Cardiology Source Type: news

Drug for Clot in Lung Helps -- at a Price (CME/CE)
(MedPage Today) -- A shot of thrombolytic therapy substantially improved outcomes in intermediate-risk pulmonary embolism in a randomized trial, but the improvement came at a price in bleeding and stroke that is likely to keep acceptance low. (Source: MedPage Today Emergency Medicine)
Source: MedPage Today Emergency Medicine - April 9, 2014 Category: Emergency Medicine Source Type: news

Stroke Rounds: Early Surgery Looks Safe After tPA
(MedPage Today) -- Performing carotid endarterectomy or stenting in patients who were recently treated with thrombolytic therapy for an acute stroke appeared to be safe, an observational study showed. (Source: MedPage Today Cardiovascular)
Source: MedPage Today Cardiovascular - March 11, 2014 Category: Cardiology Source Type: news

Stroke: Initiative Cuts Time to tPA (CME/CE)
SAN DIEGO (MedPage Today) -- An effort to shorten the time between when patients with acute ischemic stroke arrive at the hospital and when they receive intravenous thrombolytic therapy -- the door-to-needle time -- proved successful, researchers found. (Source: MedPage Today Primary Care)
Source: MedPage Today Primary Care - February 17, 2014 Category: Primary Care Source Type: news

Stroke Rounds: Uric Acid Post tPA (CME/CE)
SAN DIEGO (MedPage Today) -- Despite missing its primary endpoint, a randomized trial suggested that giving uric acid after intravenous thrombolytic therapy to patients with acute ischemic stroke might help improve outcomes. (Source: MedPage Today Meeting Coverage)
Source: MedPage Today Meeting Coverage - February 13, 2014 Category: Journals (General) Source Type: news

Stroke in a young patient? Ask about synthetic cannabinoids
3 out of 5 stars Ischemic stroke after use of synthetic marijuana “spice”. Freeman MJ et al. Neurology 2013;81:1-4. Abstract This interesting paper, from the University of South Florida in Tampa, describes a brother and sister who at different times both developed ischemic strokes shortly after smoking a synthetic marijuana product. The 26-year-old brother presented with dysarthria, expressive aphasia, and right-sided weakness after smoking “Spice” a few hours previously. Head CT showed a clot in the proximal middle cerebral artery. His symptoms resolved after treatment with thrombolytics. The ...
Source: The Poison Review - December 11, 2013 Category: Toxicology Authors: Leon Tags: Medical cerebral ischemia jwh-018 spice stroke synthetic cannabinoid Source Type: news

Clot-Busting Drugs Used More Often in Stroke (CME/CE)
(MedPage Today) -- Stroke patients eligible for thrombolytic therapy have significantly better odds of receiving the therapy than they did a few years ago, according to a review of more than a million stroke cases. (Source: MedPage Today Cardiovascular)
Source: MedPage Today Cardiovascular - August 23, 2013 Category: Cardiology Source Type: news

Earlier the Better for Stroke Treatment (CME/CE)
(MedPage Today) -- The earlier within the recommended treatment window that intravenous thrombolytic therapy was administered, the better the outcomes following ischemic stroke, an observational study showed. (Source: MedPage Today State Required CME)
Source: MedPage Today State Required CME - August 22, 2013 Category: Consumer Health News Source Type: news

Why Women Trail Men in Clot-Busting Tx (CME/CE)
(MedPage Today) -- Women were less likely than men to receive intravenous thrombolytic therapy for acute stroke, which could have to do with delayed arrival at the hospital, researchers found. (Source: MedPage Today Geriatrics)
Source: MedPage Today Geriatrics - July 26, 2013 Category: Geriatrics Source Type: news

Clot Busters Offer Long-Term Benefits (CME/CE)
(MedPage Today) -- Stroke patients continued to benefit from thrombolytic therapy for at least a year and a half after treatment, long-term follow-up from a randomized trial showed. (Source: MedPage Today State Required CME)
Source: MedPage Today State Required CME - June 21, 2013 Category: Consumer Health News Source Type: news

PEITHO: Persuasive for Thrombolysis in PE?PEITHO: Persuasive for Thrombolysis in PE?
The largest trial ever conducted in the setting of intermediate-risk pulmonary embolism indicates that a bolus of thrombolytic therapy with tenecteplase may be of benefit in those younger than 75. In older patients, it would seem the risks outweigh the benefits. Heartwire (Source: Medscape Today Headlines)
Source: Medscape Today Headlines - March 12, 2013 Category: Consumer Health News Tags: Cardiology News Source Type: news

PEITHO: Persuasive for thrombolysis in PE?
The largest trial ever conducted in the setting of intermediate-risk pulmonary embolism indicates that a bolus of thrombolytic therapy with tenecteplase may be of benefit in those younger than 75. In older patients, it would seem the risks outweigh the benefits. (Source: theHeart.org)
Source: theHeart.org - March 11, 2013 Category: Cardiology Source Type: news

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

Endovascular Tx Does Not Top Clot-Buster (CME/CE)
(MedPage Today) -- Compared with intravenous thrombolytic therapy, endovascular therapy did not improve outcomes in patients with acute ischemic stroke, an Italian trial showed. (Source: MedPage Today Cardiovascular)
Source: MedPage Today Cardiovascular - February 6, 2013 Category: Cardiology Source Type: news

MRI tool helps spot damage to blood-brain barrier in stroke
A software tool used with standard MRI may provide a clearer picture of the extent of blood-brain-barrier damage in acute stroke, possibly helping to predict risk of ICH with thrombolytic therapy. (Source: theHeart.org)
Source: theHeart.org - January 23, 2013 Category: Cardiology Source Type: news

MRI Tool Helps Spot Damage to Blood-Brain Barrier in StrokeMRI Tool Helps Spot Damage to Blood-Brain Barrier in Stroke
A software tool used with standard MRI may provide a clearer picture of the extent of damage to the blood-brain barrier in acute stroke, possibly helping to predict risk for ICH with thrombolytic therapy. Medscape Medical News (Source: Medscape Today Headlines)
Source: Medscape Today Headlines - January 23, 2013 Category: Consumer Health News Tags: Neurology & Neurosurgery News Source Type: news

"Barrier-to-use" review boosts thrombolytic use in community hospitals
Identifying and addressing barriers to thrombolytic therapy helped increase use in nonspecialty community hospitals across Michigan. (Source: theHeart.org)
Source: theHeart.org - January 9, 2013 Category: Cardiology Source Type: news

Intervention Boosts Thrombolytic Use in Community HospitalsIntervention Boosts Thrombolytic Use in Community Hospitals
Identifying and addressing barriers to thrombolytic therapy helped increase use in nonspecialty community hospitals across Michigan. Medscape Medical News (Source: Medscape Today Headlines)
Source: Medscape Today Headlines - January 9, 2013 Category: Consumer Health News Tags: Neurology & Neurosurgery News Source Type: news