19,455 results match your criteria response thrombolytic

[Inferior vena cava agenesis presenting as deep vein thrombosis. Report of one case].

Rev Med Chil 2020 Dec;148(12):1833-1837

Hospital San Martín de Quillota, Quillota, Chile.

Abnormalities of the inferior vena cava are rare. Its embryological development occurs between the sixth and eighth week of gestation and depends on the persistence or regression of three pairs of veins: the posterior cardinal veins, the subcardinal veins and the supracardinal veins. The type of congenital alteration depends on the moment that embryogenesis is altered. Read More

View Article and Full-Text PDF
December 2020

Management of Acute Pulmonary Embolism With a Pulmonary Embolism Response Team.

J Am Board Fam Med 2021 Mar-Apr;34(2):402-408

From the Division of Cardiology, Yale University, New Haven, CT (JC); Division of Cardiology, Medical College of Georgia at the Augusta University Medical Center (VA); and the Department of Family Medicine, Medical College of Georgia at the Augusta University Medical Center, Augusta (TW).

Despite recent advances in the assessment, risk stratification, and treatment of acute pulmonary embolism (PE), it remains a leading cause of cardiovascular morbidity and mortality in the United States each year. Patient presentation and prognosis are heterogeneous, and a variety of diagnostic and therapeutic instruments have arisen to assist in providing patients with the appropriate level of care and aggressiveness of approach. Fortunately, a growing number of institutions now have pulmonary embolism response teams (PERT) that urgently assist with risk assessment and management of patients with massive and sub-massive PE. Read More

View Article and Full-Text PDF

The relationship between cardiac injury, inflammation and coagulation in predicting COVID-19 outcome.

Sci Rep 2021 03 22;11(1):6515. Epub 2021 Mar 22.

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

High sensitivity troponin T (hsTnT) is a strong predictor of adverse outcome during SARS-CoV-2 infection. However, its determinants remain partially unknown. We aimed to assess the relationship between severity of inflammatory response/coagulation abnormalities and hsTnT in Coronavirus Disease 2019 (COVID-19). Read More

View Article and Full-Text PDF

Effect of intravenous thrombolysis with alteplase on clinical efficacy, inflammatory factors, and neurological function in patients with acute cerebral infarction.

Braz J Med Biol Res 2021 15;54(5):e10000. Epub 2021 Mar 15.

Department of Neurology, The People's Hospital of Beilun District, Beilun Branch Hospital of The First Affiliated Hospital, Zhejiang University School of Medicine, Ningbo, Zhejiang Province, China.

This study aimed to explore the effect of intravenous thrombolysis with alteplase on clinical efficacy, inflammatory factors, and neurological function in patients with acute cerebral infarction. A total of 120 patients with acute cerebral infarction were divided into two groups by the random number table method, with 60 patients in each group: observation group (intravenous thrombolysis with alteplase) and control group (intravenous thrombolysis with batroxobin). The clinical efficacy after a 14-day treatment was observed. Read More

View Article and Full-Text PDF

Defining Kawasaki disease and pediatric inflammatory multisystem syndrome-temporally associated to SARS-CoV-2 infection during SARS-CoV-2 epidemic in Italy: results from a national, multicenter survey.

Pediatr Rheumatol Online J 2021 Mar 16;19(1):29. Epub 2021 Mar 16.

University of Trieste, Piazzale Europa, 2, Trieste, Italy.

Background: There is mounting evidence on the existence of a Pediatric Inflammatory Multisystem Syndrome-temporally associated to SARS-CoV-2 infection (PIMS-TS), sharing similarities with Kawasaki Disease (KD). The main outcome of the study were to better characterize the clinical features and the treatment response of PIMS-TS and to explore its relationship with KD determining whether KD and PIMS are two distinct entities.

Methods: The Rheumatology Study Group of the Italian Pediatric Society launched a survey to enroll patients diagnosed with KD (Kawasaki Disease Group - KDG) or KD-like (Kawacovid Group - KCG) disease between February 1st 2020, and May 31st 2020. Read More

View Article and Full-Text PDF

Inside the Thrombus: Association of Hemostatic Parameters With Outcomes in Large Vessel Stroke Patients.

Front Neurol 2021 22;12:599498. Epub 2021 Feb 22.

Laboratory of Atherothrombosis, CIMA-Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra, IdisNA, Pamplona, Spain.

Actual clinical management of ischemic stroke (IS) is based on restoring cerebral blood flow using tissue plasminogen activator (tPA) and/or endovascular treatment (EVT). Mechanical thrombectomy has permitted the analysis of thrombus structural and cellular classic components. Nevertheless, histological assessment of hemostatic parameters such as thrombin-activatable fibrinolysis inhibitor (TAFI) and matrix metalloproteinase 10 (MMP-10) remains unknown, although their presence could determine thrombus stability and its response to thrombolytic treatment, improving patient's outcome. Read More

View Article and Full-Text PDF
February 2021

Coagulopathy of hospitalised COVID-19: A Pragmatic Randomised Controlled Trial of Therapeutic Anticoagulation versus Standard Care as a Rapid Response to the COVID-19 Pandemic (RAPID COVID COAG - RAPID Trial): A structured summary of a study protocol for a randomised controlled trial.

Trials 2021 Mar 10;22(1):202. Epub 2021 Mar 10.

St. Michael's Hospital, Applied Health Research Centre, Li Ka Shing Knowledge Institute, University of Toronto, Toronto, Canada.

Objectives: To determine the effect of therapeutic anticoagulation, with low molecular weight heparin (LMWH) or unfractionated heparin (UFH, high dose nomogram), compared to standard care in hospitalized patients admitted for COVID-19 with an elevated D-dimer on the composite outcome of intensive care unit (ICU) admission, non-invasive positive pressure ventilation, invasive mechanical ventilation or death up to 28 days.

Trial Design: Open-label, parallel, 1:1, phase 3, 2-arm randomized controlled trial PARTICIPANTS: The study population includes hospitalized adults admitted for COVID-19 prior to the development of critical illness. Excluded individuals are those where the bleeding risk or risk of transfusion would generally be considered unacceptable, those already therapeutically anticoagulated and those who have already have any component of the primary composite outcome. Read More

View Article and Full-Text PDF

[Interferon gamma in the treatment of patients with moderate COVID-19].

Vopr Virusol 2021 03 7;66(1):47-54. Epub 2021 Mar 7.

FSBI National Research Centre of Epidemiology and Microbiology named after honorary academician N.F. Gamaleya of the Ministry of Health of Russia.

Introduction: Interferons are produced in response to the presence of pathogens in cells and are responsible for the proper formation of immune reaction. Preliminary data obtained in studies of properties of recombinant interferon gamma (IFN-γ) that involved patients with community-acquired pneumonia (including bacterial), acute respiratory viral infection (ARVI), influenza and new coronavirus infection have shown promising results.The purpose of the study was to assess the effect of subcutaneous administration of IFN-γ in patients with viral pneumonia on the changes of vital signs and the duration of hospital stay. Read More

View Article and Full-Text PDF

Potential repurposing of the HDAC inhibitor valproic acid for patients with COVID-19.

Eur J Pharmacol 2021 May 2;898:173988. Epub 2021 Mar 2.

Department of Internal Medicine, Division of Cardiovascular Medicine, Michigan Medicine, Ann Arbor, MI, USA; Department of Pharmacology, University of Michigan Medical School, Ann Arbor, MI, USA.

There is a need for therapeutic approaches to prevent and mitigate the effects of Coronavirus Disease (2019) (COVID-19). The histone deacetylase (HDAC) inhibitor valproic acid, which has been available for the therapy of epilepsy for many years, is a drug that could be repurposed for patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. This article will review the reasons to consider valproic acid as a potential therapeutic to prevent severe COVID-19. Read More

View Article and Full-Text PDF

Old drug, new Trick? The rationale for the treatment of COVID-19 with activated protein C.

Steven B Pestka

Med Hypotheses 2021 Apr 16;149:110537. Epub 2021 Feb 16.

Tufts University School of Medicine, Department of Medicine, Newton-Wellesley Hospital, 2014 Washington Street, Newton, MA 02462, USA. Electronic address:

As the COVID-19 pandemic continues, researchers seek to identify efficacious treatments. Current approaches to COVID-19 therapeutics focus on antiviral agents, convalescent plasma, monoclonal antibodies, immunomodulators and more traditional therapies such as steroids [1-6]. Reversing disturbances in coagulation has also been identified as a priority area for candidate therapies, such as through the Accelerating COVID-19 Therapeutic Interventions and Vaccines 4 adaptive clinical trial (ACTIV-4) which is currently evaluating aspirin, heparins and apixaban [7]. Read More

View Article and Full-Text PDF

Troxerutin Improves Dextran Sulfate Sodium-Induced Ulcerative Colitis in Mice.

J Agric Food Chem 2021 Mar 23;69(9):2729-2744. Epub 2021 Feb 23.

Department of Cell Biology, Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou 221009, Jiangsu, China.

Screening potential compounds for improving ulcerative colitis (UC) from clinical medication is an effective strategy for drug repurposing. We applied bioinformatics and network pharmacology to the drug screening process in this study, which helped us to screen out troxerutin that could improve UC. Troxerutin belongs to flavonoids and is used clinically as an anticoagulant and thrombolytic agent. Read More

View Article and Full-Text PDF

Size- and charge-dependent modulation of the lytic susceptibility and mechanical stability of fibrin-histone clots by heparin and polyphosphate variants.

J Thromb Haemost 2021 Feb 20. Epub 2021 Feb 20.

Department of Biochemistry, Institute of Biochemistry and Molecular Biology, Semmelweis University, Budapest, Hungary.

Background: Neutrophil extracellular traps (NETs) containing DNA and histones are expelled from neutrophils in infection and thrombosis. Heparins, anticoagulant polyanions, can neutralize histones with a potential therapeutic advantage in sepsis. Polyphosphates, procoagulant polyanions, are released by platelets and microorganisms. Read More

View Article and Full-Text PDF
February 2021

The clot thickens: role of mechanical thrombectomy in intermediate to high-risk pulmonary embolism in the peri-operative setting-a case report.

Eur Heart J Case Rep 2021 Feb 4;5(2):ytab014. Epub 2021 Feb 4.

Division of Cardiology, Rush University Medical Center, Chicago, IL, 60612, USA.

Background: European Society of Cardiology (ESC) recommends catheter-directed thrombectomy for management of high-risk pulmonary embolism (PE) with contraindications to thrombolytics or in patients that have failed thrombolytic therapy, as well as intermediate-risk PE with haemodynamic deterioration. In this case report, the role of catheter-directed mechanical thrombectomy is highlighted in the urgent peri-operative setting.

Case Summary: A 71-year-old female presented with 10 days of progressive lower extremity weakness and was found to have malignant cord compression along with incidental saddle, intermediate-high-risk PE that extended to all lobes on chest computed tomography. Read More

View Article and Full-Text PDF
February 2021

Plasminogen Receptors and Fibrinolysis.

Int J Mol Sci 2021 Feb 8;22(4). Epub 2021 Feb 8.

Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA and Veterans Administration San Diego Healthcare System, San Diego, CA 92161, USA.

The ability of cells to promote plasminogen activation on their surfaces is now well recognized, and several distinct cell surface proteins have been demonstrated to function as plasminogen receptors. Here, we review studies demonstrating that plasminogen bound to cells, in addition to plasminogen directly bound to fibrin, plays a major role in regulating fibrin surveillance. We focus on the ability of specific plasminogen receptors on eukaryotic cells to promote fibrinolysis in the in vivo setting by reviewing data obtained predominantly in murine models. Read More

View Article and Full-Text PDF
February 2021

Therapeutic Potential of Resveratrol in COVID-19-Associated Hemostatic Disorders.

Molecules 2021 Feb 6;26(4). Epub 2021 Feb 6.

Department of Medical Laboratory Sciences, College of Health Sciences, and Sharjah Institute for Medical Research, University of Sharjah, University City Rd, Sharjah 27272, United Arab Emirates.

Coagulation disorders, endotheliopathy and inflammation are the most common hallmarks in SARS-CoV-2 infection, largely determining COVID-19's outcome and severity. Dysfunctions of endothelial cells and platelets are tightly linked in contributing to the systemic inflammatory response that appears to be both a cause and a consequence of COVID-19-associated coagulation disorders and thrombotic events. Indeed, elevated levels of circulating inflammatory cytokines are often associated with abnormal coagulation parameters in COVID-19 patients. Read More

View Article and Full-Text PDF
February 2021

COVID-19 and cytokine storm syndrome: can what we know about interleukin-6 in ovarian cancer be applied?

J Ovarian Res 2021 Feb 8;14(1):28. Epub 2021 Feb 8.

Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.

Improving early diagnosis along with timely and effective treatment of COVID-19 are urgently needed. However, at present, the mechanisms underlying disease spread and development, defined prognosis, and immune status of patients with COVID-19 remain to be determined. Patients with severe disease state exhibit a hyperinflammatory response associated with cytokine storm syndrome, hypercoagulability, and depressed cell-mediated immunity. Read More

View Article and Full-Text PDF
February 2021

COVID-19 and Its Implications for Thrombosis and Anticoagulation.

Semin Respir Crit Care Med 2021 04 6;42(2):316-326. Epub 2021 Feb 6.

Department of Medicine, Cedars Sinai Medical Center, Los Angeles, California.

Venous thromboembolism, occlusion of dialysis catheters, circuit thrombosis in extracorporeal membrane oxygenation (ECMO) devices, acute limb ischemia, and isolated strokes, all in the face of prophylactic and even therapeutic anticoagulation, are features of novel coronavirus disease 2019 (COVID-19) coagulopathy. It seems well established at this time that a COVID-19 patient deemed sick enough to be hospitalized, should receive at least prophylactic dose anticoagulation. However, should some hospitalized patients have dosage escalation to intermediate dose? Should some be considered for full-dose anticoagulation without a measurable thromboembolic event and how should that anticoagulation be monitored? Should patients receive postdischarge anticoagulation and with what medication and for how long? What thrombotic issues are related to the various medications being used to treat this coagulopathy? Is antiphospholipid antibody part of this syndrome? What is the significance of isolated ischemic stroke and limb ischemia in this disorder and how does this interface with the rest of the clinical and laboratory features of this disorder? The aims of this article are to explore these questions and interpret the available data based on the current evidence. Read More

View Article and Full-Text PDF

Low-Dose vs Standard-Dose Alteplase in Acute Lacunar Ischemic Stroke: The ENCHANTED Trial.

Neurology 2021 03 3;96(11):e1512-e1526. Epub 2021 Feb 3.

From The George Institute for Global Health, Faculty of Medicine (Z.Z., C.D., C.X., S. Yoshimura, C.C., T.T.-Y., A.M., X.C., M.L.H., M.W., J.C., C.S.A.), and South Western Clinical School (M.W.P.), University of New South Wales Sydney, Australia; Department of Radiology (Z.Z., J.X.), Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, China; Department of Neurology (C.D., C.C., C.S.A.), Royal Prince Alfred Hospital, Sydney Health Partners; Sydney Medical School (C.D., C.C.), University of Sydney, Australia; Department of Neurosurgery (C.X.), West China Hospital, Sichuan University, Chengdu, China; Department of Cerebrovascular Medicine (S. Yoshimura, T.T.-Y.), National Cerebral and Cardiovascular Center, Osaka; Department of Neurology and Neuroscience (T.T.-Y.), Nagoya City University Graduate School of Medical Science, Japan; Department of Neurology (S. You), the Second Affiliated Hospital of Soochow University, Suzhou, China; The George Institute for Global Health, School of Public Health (M.W.), Imperial College, London; Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Center (T.G.R.), University of Leicester, UK; Melbourne Brain Centre, Royal Melbourne Hospital University Department of Medicine (M.W.P.), University of Melbourne, Australia; Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, Cumming School of Medicine (A.M.D.), University of Calgary, Canada; Westmead Applied Research Centre (R.I.L.), University of Sydney, Australia; Division of Neuroimaging Sciences, Edinburgh Imaging and Centre for Clinical Brain Sciences (G.M., J.M.W.), and UK Dementia Research Institute (J.M.W.), University of Edinburgh; and The George Institute China at Peking University Health Science Center (C.S.A.), Beijing, China.

Objective: To determine any differential efficacy and safety of low- vs standard-dose IV alteplase for lacunar vs nonlacunar acute ischemic stroke (AIS), we performed post hoc analyzes from the Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED) alteplase dose arm.

Methods: In a cohort of 3,297 ENCHANTED participants, we identified those with lacunar or nonlacunar AIS with different levels of confidence (definite/according to prespecified definitions based on clinical and adjudicated imaging findings. Logistic regression models were used to determine associations of lacunar AIS with 90-day outcomes (primary, modified Rankin Scale [mRS] scores 2-6; secondary, other mRS scores, intracerebral hemorrhage [ICH], and early neurologic deterioration or death) and treatment effects of low- vs standard-dose alteplase across lacunar and nonlacunar AIS with adjustment for baseline covariables. Read More

View Article and Full-Text PDF

The Challenge of Tightening Door-to-Needle Timings in a Telestroke Setting: An Emergency Medicine Driven Initiative.

Cureus 2020 Dec 27;12(12):e12316. Epub 2020 Dec 27.

Emergency Medicine, Changi General Hospital, Singapore, SGP.

Introduction Administering intravenous thrombolytic therapy within 60 minutes on arrival in any healthcare facility is challenging, especially when done by Emergency Medicine Physicians (EMP) via telemedicine in centres without onsite neurology cover. Prior quality improvement interventions have improved median Door-to-Needle (DTN) timings in our centre; however, it still falls short of the DTN target of 60 minutes.  Methods Various quality improvement interventions were implemented over four months by a multi-disciplinary telestroke workgroup led by EMPs to improve DTN timings for patients presenting with acute ischaemic strokes. Read More

View Article and Full-Text PDF
December 2020

Kawasaki Disease like Multisystem Inflammatory Syndrome in a Toddler during SARS-CoV-2 Pandemic in Nepal.

J Nepal Health Res Counc 2021 Jan 22;18(4):789-791. Epub 2021 Jan 22.

Department of Pediatrics, Kanti Children's Hospital, Kathmandu, Nepal.

Multisystem inflammatory syndrome in children is a new childhood inflammatory disorder associated with respiratory syndrome coronavirus 2 (SARS-CoV-2). This illness of elevated inflammatory markers and multiple organ involvement similar to Kawasaki disease is not commonly reported from Asia. A 17-month-old boy presented with acute onset fever, rash, non-exudative conjunctivitis and swellings of hands and legs. Read More

View Article and Full-Text PDF
January 2021

[Preparation and in vitro quality evaluation of self-microemulsion co-loaded with tenuifolin and β-asarone].

Zhongguo Zhong Yao Za Zhi 2020 Dec;45(24):5988-5995

Department of Pharmac,Air Force Medical Center Beijing 100142, China.

To prepare and optimize the self-microemulsion co-loaded with tenuifolin and β-asarone(TF/ASA-SMEDDS) and evaluate its quality. The prescription compositions of TF/ASA-SMEDDS were screened by solubility test, single factor test and pseudo-tern-ary phase diagram, and the prescriptions were further optimized by Box-Behnken response surface method, with the drug loading and particle size as the evaluation indexes. Then the optimized TF/ASA-SMEDDS was evaluated for emulsified appearance, particle size, morphology and drug release in vitro. Read More

View Article and Full-Text PDF
December 2020

Tissue Plasminogen Activator Use in Pediatric Patients: A Single Center Experience.

J Pediatr Hematol Oncol 2021 Jan 20. Epub 2021 Jan 20.

Gaziantep University School of Medicine, Gaziantep Ankara University School of Medicine, Ankara, Turkey.

Introduction: Thrombosis is rare in children and antithrombolytic treatment is controversial. Most commonly used thrombolytic agent is tissue plasminogen activator (t-PA) in pediatrics. In this study, we report our experience in the use of thrombolytic treatment. Read More

View Article and Full-Text PDF
January 2021

Response to "Pulmonary Embolism: Putting the Horse Back in Front of the Cart".

J Vasc Interv Radiol 2021 03 16;32(3):481-482. Epub 2021 Jan 16.

Department of Vascular and Interventional Radiology, Christiana Care Health System, 4755 Ogletown Stanton Road, Suite 1e20, Newark, DE 19718.

View Article and Full-Text PDF

Multifactorial Background for a Low Biological Response to Antiplatelet Agents Used in Stroke Prevention.

Adam Wiśniewski

Medicina (Kaunas) 2021 Jan 10;57(1). Epub 2021 Jan 10.

Department of Neurology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Skłodowskiej 9 Street, 85-094 Bydgoszcz, Poland.

Effective platelet inhibition is the main goal of the antiplatelet therapy recommended as a standard treatment in the secondary prevention of non-embolic ischemic stroke. Acetylsalicylic acid (aspirin) and clopidogrel are commonly used for this purpose worldwide. A low biological response to antiplatelet agents is a phenomenon that significantly reduces the therapeutic and protective properties of the therapy. Read More

View Article and Full-Text PDF
January 2021

Unveiling pharmacological studies provide new insights on and .

Saudi J Biol Sci 2021 Jan 24;28(1):183-190. Epub 2020 Sep 24.

Department of Pharmacology, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia.

and both is an ethnomedicinally important Asian herb that has been known for numerous healing activity of tribal people. The present research aims to investigate the phytochemical analysis with , possibilities of the soluble ethanol extract of root (EEMLR) and leaves (EEQGL) by an experimental approach. The plant extract of EEMLR and EEQGL was found secondary metabolites, notably steroids, glycosides, tannins, flavonoids, saponins, gums, and alkaloids. Read More

View Article and Full-Text PDF
January 2021

Impaired fibrinolysis in critically ill COVID-19 patients.

Br J Anaesth 2021 03 9;126(3):590-598. Epub 2020 Dec 9.

Department of Anaesthesiology and Critical Care Medicine, Innsbruck, Austria.

Background: Critically ill coronavirus disease 2019 (COVID-19) patients present with a hypercoagulable state with high rates of macrovascular and microvascular thrombosis, for which hypofibrinolysis might be an important contributing factor.

Methods: We retrospectively analysed 20 critically ill COVID-19 patients at Innsbruck Medical University Hospital whose coagulation function was tested with ClotPro® and compared with that of 60 healthy individuals at Augsburg University Clinic. ClotPro is a viscoelastic whole blood coagulation testing device. Read More

View Article and Full-Text PDF