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Thrombolytic Therapy in Stroke

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Apigenin-7-O-β-d-(6″-p-coumaroyl)-glucopyranoside reduces myocardial ischaemia/reperfusion injury in an experimental model via regulating the inflammation response.

Wei Quan, Shanbo Ma, Yanrong Zhu, Qing Shao, Jixing Hou, Xiaoqiang Li,

Context: Traditionally, Clematis tangutica Korsh. (Ranunculaceae) is used as a Tibetan herb for treating indigestion and blood stasis in China. Recently, a flavonoid glycoside, apigenin-7-O-β-d-(6″-p-coumaroyl)-glucopyranoside (APG), was isolated from the whole plant of C. tangutica.Objective: To investigate the cardioprotective effects of APG against myocardial ischaemia/reperfusion injury (MI/RI) and the possible ... Read more >>

Pharm Biol (Pharmaceutical biology)
[2020, 58(1):80-88]

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Efficacy of cattle encephalon glycoside and ignotin in patients with acute cerebral infarction: a randomized, double-blind, parallel-group, placebo-controlled study.

Hui Zhang, Chuan-Ling Li, Feng Wan, Su-Juan Wang, Xiu-E Wei, Yan-Lei Hao, Hui-Lin Leng, Jia-Min Li, Zhong-Rui Yan, Bao-Jun Wang, Ren-Shi Xu, Ting-Min Yu, Li-Chun Zhou, Dong-Sheng Fan,

Cattle encephalon glycoside and ignotin (CEGI) injection is a compound preparation formed by a combination of muscle extract from healthy rabbits and brain gangliosides from cattle, and it is generally used as a neuroprotectant in the treatment of central and peripheral nerve injuries. However, there is still a need for ... Read more >>

Neural Regen Res (Neural regeneration research)
[2020, 15(7):1266-1273]

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Ischemic stroke with a preceding Trans ischemic attack(TIA) less than 24 hours and  thrombolytic therapy

Thomas Nathaniel, Nicolas Poupore, Dan Strat, Tristan Mackey, Ashley Snell,

<title>Abstract</title> <p> Background Acute ischemic stroke attack with and without a recent TIA within or less than 24 hours may differ in clinical risk factors, and this may affect treatment outcomes following thrombolytic therapy. We examined whether the odds of exclusion or inclusion for thrombolytic therapy are greater ... Read more >>

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Factors delaying intravenous thrombolytic therapy in acute ischaemic stroke: a systematic review of the literature.

Angelos Sharobeam, Brett Jones, Dianne Walton-Sonda, Christian J Lueck,

BACKGROUND/AIMS:This review examined factors that delay thrombolysis and what management strategies are currently employed to minimise this delay, with the aim of suggesting future directions to overcome bottlenecks in treatment delivery. METHODS:A systematic review was performed according to PRISMA guidelines. The search strategy included a combination of synonyms and controlled ... Read more >>

J. Neurol. (Journal of neurology)
[2020, :]

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GRACE score and cardiovascular outcomes prediction among the delayed coronary intervention after post-fibrinolytic STEMI patients in a limited PCI-capable hospital.

Yotsawee Chotechuang, Arintaya Phrommintikul, Srun Kuanprasert, Roungtiva Muenpa, Chidchanok Ruengorn, Jayanton Patumanond, Tuanchai Chaichuen, Noparat Thanachaikun, Thanawat Benjanuwatra, Apichard Sukonthasarn,

Background:In Thailand, due to limited availability of percutaneous coronary intervention (PCI)-capable hospitals, a number of patients with ST-elevation myocardial infarction (STEMI) after fibrinolytic therapy underwent the delayed coronary intervention (24 hours to 2 weeks). Existing tool such as the Global Registry of Acute Coronary Event (GRACE) to define patients at high ... Read more >>

Open Heart (Open heart)
[2020, 7(1):e001133]

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Coronary dissection with ST elevation myocardial infarction responding to thrombolytic and conservative therapy alone.

Morteza Safi, AliReza Serati, Sepideh Emami, Mohammad Reza Movahed,

In this report, we describe a case of spontaneous coronary dissection involving left anterior descending artery presenting with acute anterior myocardial infarction successfully treated with thrombolytic and conservative therapy with a suggestion that spontaneous resolution of thrombus occurred before coronary intervention could be performed. As we did not have initial ... Read more >>

Future Cardiol (Future cardiology)
[2020, :]

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Intracranial Aneurysms After Intravenous Thrombolysis in Patient with Atrial Myxoma: A Case Study.

Zhizhang Li, Xushen Xu, Liang Hu, Hongxian Sun, Yunhua Yue,

We administered intravenous thrombolytic therapy to a 51-year-old female patient with a 101-min stroke onset. The patient was unconscious during the manifestation of symptoms. Computed tomography angiography examination of the intracranial artery at the time of admission suggested that the left middle cerebral artery was occluded. The patient regained consciousness ... Read more >>

J Stroke Cerebrovasc Dis (Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association)
[2020, :104796]

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A Case Report: An Acute Spinal Epidural Hematoma after Acupuncture Mimicking Stroke.

Chieh-Ling Chen, Ming-Hong Chang, Wei-Ju Lee,

BACKGROUND:Spinal epidural hematoma (SEH) after acupuncture is rare and may present with acute or subacute onset and varied symptoms, making it difficult to diagnose. This condition can mimic acute stroke, so it is vital to establish a clear diagnosis before considering thrombolytic therapy, which could be disastrous if applied inappropriately. ... Read more >>

J Emerg Med (The Journal of emergency medicine)
[2020, :]

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Women and In-hospital Stroke Code Activation: Age, Ethnicity, and Unique Symptoms Matter.

Renee Colsch,

BACKGROUND:Women have worse stroke outcomes than men, and almost 17% of all stroke cases have symptom onset when admitted to the hospital for a separate condition. OBJECTIVE:The aim of this study was to investigate the distinctive factors that impact the activation of an in-hospital stroke code and outcomes in women ... Read more >>

J Cardiovasc Nurs (The Journal of cardiovascular nursing)
[2020, :]

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How to balance acute myocardial infarction and COVID-19: the protocols from Sichuan Provincial People's Hospital.

Jie Zeng, Jianxin Huang, Lingai Pan,

Intensive Care Med (Intensive care medicine)
[2020, :]

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Efficacy and safety of cinepazide maleate injection in patients with acute ischemic stroke: A multicenter, randomized, double-blind, placebo-controlled trial

Liying Cui, Jun Ni, Huisheng Chen, Guofang Chen, Yong Ji, Fei Yi, Zhuobo Zhang, Yi Yang, Jin Wu, Xueli Cai, Bei Shao, Jianfeng Wang, Yafang Liu, Deqin Geng, Xinhui Qu, Xiaohong Li, Yan Wei, Jianping Ding, Hua Lu, Yining Huang, Yonghua Huang, Bo Xiao, Tao Gong,

<title>Abstract</title> <p> Background: Ischemic stroke is a leading cause of morbidity and mortality. Thrombolytic therapy improves disability and survival rates; however, to be effective, it must be given within 4.5 hours of onset. Moreover, thrombolytic therapy is frequently contraindicated. Therefore, alternative therapeutic options are required. In China, cinepazide ... Read more >>

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Is intravenous thrombolysis safe for acute ischemic stroke patients taking warfarin with INR 1.9?: A case report.

Zhaokun Li, Jing Su, Shanshan Zhang, Hongcai Du, Yufeng Tang, Jingfeng Duan, Zhonglun Chen,

INTRODUCTION:Intravenous thrombolysis is not suitable for patients undergoing oral anticoagulants therapy, with INR > 1.7 or PT > 15 s. We described a case of intravenous thrombolysis in a patient with INR 1.9. PATIENT CONCERNS:A 66-year-old female patient was diagnosed with acute appendicitis complicated with atrial fibrillation. Seven days after admission, ... Read more >>

Medicine (Baltimore) (Medicine)
[2020, 99(10):e19358]

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Efficacy and Safety of Thrombolytic Therapy for Stroke with Unknown Time of Onset: A Meta-Analysis of Observational Studies.

Ruo-Lin Zhu, Jing Xu, Cheng-Juan Xie, Ying Hu, Kai Wang,

BACKGROUND:Recombinant tissue plasminogen activator (rt-PA) is one of the most effective therapies available for patients with known-onset stroke (KOS). Whether rt-PA treatment would improve functional outcomes in patients with stroke with unknown time of onset (UTOS) is undetermined, we aimed to systematically assess the efficacy and safety of thrombolysis for ... Read more >>

J Stroke Cerebrovasc Dis (Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association)
[2020, :104742]

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Outcomes of thrombolytic therapy in acute ischemic stroke: mothership, drip-and-ship, and ship-and-drip paradigms.

Naruchorn Kijpaisalratana, Aurauma Chutinet, Wasan Akarathanawat, Pakkawan Vongvasinkul, Nijasri C Suwanwela,

BACKGROUND:Chulalongkorn Stroke Center is a comprehensive stroke center (CSC) located in Bangkok, Thailand. Our stroke network consists of different levels of spoke hospitals, ranging from community hospitals where thrombolytic treatment is not available, to those capable of onsite thrombolytic therapy. This study aimed to assess the time to treatment and ... Read more >>

BMC Neurol (BMC neurology)
[2020, 20(1):45]

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Lessons of the month 2: FAST is not always FAST.

Muhammad Ia Qureshi, Ayman Osman,

Thrombolytic treatment with tissue plasminogen activator is an established therapy for selected patients with ischaemic stroke within a narrow time window of 3 hours from the onset of symptoms. However, severe complications and poor outcomes are likely to ensue if a patient with acute aortic dissection is inadvertently treated with ... Read more >>

Clin Med (Lond) (Clinical medicine (London, England))
[2020, 20(2):219-220]

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Mechanical recanalization for acute bilateral cerebral artery occlusion - literature overview with a case.

Miran Jeromel, Zoran V Milosevic, Janja Pretnar Oblak,

Background Acute bilateral internal carotid artery (ICA) and/or middle cerebral artery (MCA) occlusion is extremely rare and associated with poor clinical outcomes. There are only a few reports in the literature about mechanical thrombectomy being performed for acute bilateral occlusions. The treatment strategies and prognoses (clinical outcomes) are therefore unclear. ... Read more >>

Radiol Oncol (Radiology and oncology)
[2020, :]

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Stroke following successful PTMC in a patient with severe mitral stenosis: A case report and presenting a simple stepwise approach to PTMC-related stroke.

Mohammad Hasan Namazi, Isa Khaheshi, Alireza Kaveh, Fatemeh Taherian, Mohammadreza Naderian, Mohammadreza Tabary,

Stroke following percutaneous trans-septal mitral commissurotomy (PTMC) is a striking complication that could significantly affect quality of life of the patients, particularly the young and active ones. We present a middle-aged woman who experienced stroke following PTMC and successfully treated with thrombolytic therapy regarding the potential adverse effects of this ... Read more >>

Cardiovasc Hematol Disord Drug Targets (Cardiovascular & hematological disorders drug targets)
[2020, :]

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3-Month Outcome of Ischemic Stroke Patients Underwent Thrombolytic Therapy; a Cohort Study.

Payam Sari Aslani, Shahab Rezaeian, Elham Safari,

Introduction:Reperfusion and neuroprotection are 2 main treatment strategies exist for management of patients with ischemic stroke. This study aimed to assess the 3-month outcome of patients who underwent thrombolytic therapy following ischemic stroke. Methods:In the present prospective cohort study, the 3-month outcome of patients (mortality, disability) with acute ischemic stroke ... Read more >>

Arch Acad Emerg Med (Archives of academic emergency medicine)
[2020, 8(1):e6]

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Mitochondrial quality control in cardiac microvascular ischemia-reperfusion injury: New insights into the mechanisms and therapeutic potentials.

Jin Wang, Sam Toan, Hao Zhou,

Thrombolytic therapy and revascularization strategies create a complete recanalization of the occluded epicardial coronary artery in patients with myocardial infarction (MI). However, about 35 % of patients still experience an impaired myocardial reperfusion, which is termed a no-reflow phenomenon mainly caused by cardiac microvascular ischemia-reperfusion (I/R) injury. Mitochondria are essential ... Read more >>

Pharmacol. Res. (Pharmacological research)
[2020, 156:104771]

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Editorial.

C J M Klijn, Bo Norrving,

Eur Stroke J (European stroke journal)
[2020, 5(1):3]

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Do thrombolysis outcomes differ between anterior circulation stroke and posterior circulation stroke? A systematic review and meta-analysis.

Sang-Hun Lee, Jung Hoon Han, Ileok Jung, Jin-Man Jung,

BACKGROUND:It remains unclear whether thrombolysis outcomes can be influenced by the affected vascular territory (i.e. anterior circulation stroke vs. posterior circulation stroke) in stroke patients owing to the lack of randomized controlled trials. AIMS:Using multiple comprehensive databases, we searched for observational studies of the safety and efficacy of intravenous thrombolytics ... Read more >>

Int J Stroke (International journal of stroke : official journal of the International Stroke Society)
[2020, :1747493020909634]

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The Impact of Loading Dose on Outcome in Stroke Patients Receiving Low-Dose Tissue Plasminogen Activator Thrombolytic Therapy.

Yi-Sin Wong, Sheng-Feng Sung, Chi-Shun Wu, Yung-Chu Hsu, Yu-Hsiang Su, Ling-Chien Hung, Cheung-Ter Ong,

Background:Intravenous tissue plasminogen activator (tPA) (0.9 mg/kg, maximum 90 mg) with a bolus of 10% of the total dose given within 1-2 mins is the standard therapy for patients receiving thrombolytic therapy. Low-dose (0.6 mg/kg) tPA is also approved for thrombolytic therapy for ischemic stroke patients. Low-dose tPA is associated with ... Read more >>

Drug Des Devel Ther (Drug Design, Development and Therapy)
[2020, 14:257-263]

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Relationship between fragmented QRS complexes and ejection fraction recovery in anterior ST-segment elevation myocardial infarction patients undergoing thrombolytic treatment.

Hayati Eren, Ülker Kaya, Lütfi Öcal, Ahmet Seyfeddin Gürbüz, Macit Kalçık, Adnan Abaci,

BACKGROUND:Acute anterior ST-segment elevation myocardial infarction (STEMI) is a life-threatening disease. Adverse cardiac events of acute anterior STEMI include cardiovascular death or worsening congestive heart failure. This study investigated the role of fragmented QRS complex (fQRS) in predicting insufficient ejection fraction (EF) recovery in acute anterior STEMI. METHODS:Patients with acute ... Read more >>

Coron. Artery Dis. (Coronary artery disease)
[2020, :]

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Post-stroke patients with and without thrombolysis: analysis of deglutition in the acute phase of the disease.

Elisângela de Fátima Pereira Pedra, Vanessa Laís Pontes, Aline Mansueto Mourão, Marcela Aline Braga, Laelia Cristina Caseiro Vicente,

PURPOSE:To verify the frequency and severity of dysphagia after ischemic stroke with or without thrombolysis in the acute phase; and the association among dysphagia, demographic characteristics, neurological and functional impairments and thrombolysis. METHODS:A retrospective study of the medical records of 94 patients who suffered from ischemic stroke during the acute ... Read more >>

Codas (CoDAS)
[2020, 32(1):e20180229]

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Measuring Outcome After Stroke: More Lessons Learned Again.

Patrick D Lyden,

Stroke (Stroke)
[2020, 51(4):1053-1054]

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