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[PMID]:28749042
[Au] Autor:Hooi KS; Lemetayer JD
[Ad] Endereço:Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, N1G 2W1, Canada.
[Ti] Título:The use of intravesicular alteplase for thrombolysis in a dog with urinary bladder thrombi.
[So] Source:J Vet Emerg Crit Care (San Antonio);27(5):590-595, 2017 Sep.
[Is] ISSN:1476-4431
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To describe the use of alteplase for intravesicular thrombolysis in a dog after development of urinary tract obstruction from a blood clot in the urinary bladder. CASE SUMMARY: A 5.8 kg, 6.5-year-old female neutered Bichon Frise was presented for signs of acute hematuria. A complete blood count (CBC) revealed marked thrombocytopenia and leukopenia, and nonregenerative anemia. Bone marrow aspirate cytology revealed mild hypercellularity, mild megakaryocytic hyperplasia, mildly left-shifted erythroid maturation, and moderately left-shifted myeloid maturation, suggesting ongoing recovery from an acute bone marrow insult. Thrombocytopenia and hematuria resolved concurrently; however, stranguria and oliguria developed acutely. Ultrasonography identified two large presumed thrombi within the urinary bladder. A urinary catheter was placed and 4 doses of 0.5 mg of alteplase diluted in 10 mL of 0.9% sodium chloride were instilled into the bladder with a 4-hour dwell time at 12-hour intervals. Prothombin and activated partial thromboplastin times were monitored during therapy and remained within normal limits. One thrombus was successfully dissolved after 48 hours of therapy and the remaining thrombus was reduced in size and was voided upon removal of the urinary catheter. NEW OR UNIQUE INFORMATION PROVIDED: This report describes the use of alteplase in a dog for thrombolysis of intravesicular thrombi. In patients that develop intravesicular thrombi, intravesical instillation of alteplase can be considered as a method for dissolution of these thrombi.
[Mh] Termos MeSH primário: Fibrinolíticos/uso terapêutico
Trombocitopenia/veterinária
Ativador de Plasminogênio Tecidual/uso terapêutico
Doenças da Bexiga Urinária/veterinária
[Mh] Termos MeSH secundário: Administração Intravesical
Animais
Cães
Feminino
Fibrinolíticos/administração & dosagem
Trombocitopenia/tratamento farmacológico
Trombose/tratamento farmacológico
Ativador de Plasminogênio Tecidual/administração & dosagem
Doenças da Bexiga Urinária/tratamento farmacológico
[Pt] Tipo de publicação:CASE REPORTS
[Nm] Nome de substância:
0 (Fibrinolytic Agents); EC 3.4.21.68 (Tissue Plasminogen Activator)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1111/vec.12627


  2 / 17190 MEDLINE  
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[PMID]:29203753
[Au] Autor:Starostka-Tatar A; Labuz-Roszak B; Skrzypek M; Gasior M; Gierlotka M
[Ad] Endereço:Katedra I Klinika Neurologii W Zabrzu, Slaski Uniwersytet Medyczny W Katowicach, Zabrze, Polska.
[Ti] Título:[Definition and treatment of stroke over the centuries].
[So] Source:Wiad Lek;70(5):982-987, 2017.
[Is] ISSN:0043-5147
[Cp] País de publicação:Poland
[La] Idioma:pol
[Ab] Resumo:Stroke was already diagnosed in the ancient times. For hundreds of years the treatment of this disease has changed radically. According to the current WHO definition, stroke is a clinical syndrome caused by focal or generalized brain injury that lasts more than 24 hours or leads to death and has no other cause than vascular. Stroke constitutes a big social and economic problem, as it can lead to death or disability. In the highly developed countries stroke is the third most common cause of adult deaths, the second leading cause of dementia, and the most common cause of disability. The consequences of stroke also include epilepsy and depression. In the twentieth century, stroke was only treated symptomatically and rehabilitation was limited to passive exercises. The first breakthrough in ischemic stroke therapy was the introduction of aspirin (ASA), followed by intravenous thrombolysis using recombinant tissue plasminogen activator (rtPA), initially available in our country only in the drug programs, and since 2009 it has been reimbursed by the National Health Fund (NFZ). Gradually invasive stroke treatment has been developed. Mechanical thrombectomy is currently only performed in selected centers, giving hope for more effective stroke treatment. The purpose of this work was to show how stroke treatment has changed over the centuries.
[Mh] Termos MeSH primário: Isquemia Encefálica/terapia
Reabilitação do Acidente Vascular Cerebral
Acidente Vascular Cerebral/terapia
[Mh] Termos MeSH secundário: Terapia Combinada
Fibrinolíticos/uso terapêutico
Seres Humanos
Trombectomia/métodos
Terapia Trombolítica/métodos
Ativador de Plasminogênio Tecidual/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Fibrinolytic Agents); EC 3.4.21.68 (Tissue Plasminogen Activator)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE


  3 / 17190 MEDLINE  
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[PMID]:28747462
[Au] Autor:Mistry EA; Mistry AM; Nakawah MO; Chitale RV; James RF; Volpi JJ; Fusco MR
[Ad] Endereço:From the Department of Neurology, University of Cincinnati, OH (E.A.M); Department of Neurology, Houston Methodist Neurological Institute, TX (M.O.N., J.J.V.); Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN (A.M.M., R.V.C., M.R.F.); and Department of Neurosurgery, Un
[Ti] Título:Mechanical Thrombectomy Outcomes With and Without Intravenous Thrombolysis in Stroke Patients: A Meta-Analysis.
[So] Source:Stroke;48(9):2450-2456, 2017 09.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: Whether prior intravenous thrombolysis provides any additional benefits to the patients undergoing mechanical thrombectomy for large vessel, acute ischemic stroke remains unclear. METHODS: We conducted a meta-analysis of 13 studies obtained through PubMed and EMBASE database searches to determine whether functional outcome (modified Rankin Scale) at 90 days, successful recanalization rate, and symptomatic intracerebral hemorrhage rate differed between patients who underwent mechanical thrombectomy with (MT+IVT) and without (MT-IVT) pre-treatment with intravenous thrombolysis. RESULTS: MT+IVT patients compared with MT-IVT patients had better functional outcomes (modified Rankin Scale score, 0-2; summary odds ratio [OR], 1.27 [95% confidence interval (CI), 1.05-1.55]; =0.02; n=1769/1174), lower mortality (OR, 0.71 [95% CI, 0.55-0.91]; =0.006; n=1774/1202), and higher rate of successful recanalization (OR, 1.46 [95% CI, 1.09-1.96]; =0.01; n=1652/1216) without having increased odds of symptomatic intracerebral hemorrhage (OR, 1.11 [95% CI, 0.69-1.77]; =0.67; n=1471/1143). A greater number of MT+IVT patients required ≤2 passes with a neurothrombectomy device to achieve successful recanalization (OR, 2.06 [95% CI, 1.37-3.10]; =0.0005; n=316/231). CONCLUSIONS: Our results demonstrated that MT+IVT patients had better functional outcomes, lower mortality, higher rate of successful recanalization, requiring lower number of device passes, and equal odds of symptomatic intracerebral hemorrhage compared with MT-IVT patients. The results support the current guidelines of offering intravenous thrombolysis to eligible patients even if they are being considered for mechanical thrombectomy. Because the data are compiled from studies where the 2 groups differed based on eligibility for intravenous thrombolysis, randomized trials are necessary to accurately evaluate the added value of intravenous thrombolysis in patients treated with mechanical thrombectomy.
[Mh] Termos MeSH primário: Fibrinolíticos/uso terapêutico
Acidente Vascular Cerebral/terapia
Trombectomia/métodos
Terapia Trombolítica/métodos
Ativador de Plasminogênio Tecidual/uso terapêutico
[Mh] Termos MeSH secundário: Administração Intravenosa
Hemorragia Cerebral/induzido quimicamente
Hemorragia Cerebral/epidemiologia
Terapia Combinada
Seres Humanos
Mortalidade
Razão de Chances
Complicações Pós-Operatórias/epidemiologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Nm] Nome de substância:
0 (Fibrinolytic Agents); EC 3.4.21.68 (Tissue Plasminogen Activator)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.117.017320


  4 / 17190 MEDLINE  
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[PMID]:29489640
[Au] Autor:Saad M; Shaikh DH; Adrish M
[Ad] Endereço:Department of Internal Medicine.
[Ti] Título:A rare case report of a saddle pulmonary embolism presenting with high grade fevers, responsive to anticoagulation.
[So] Source:Medicine (Baltimore);97(9):e0002, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Pulmonary embolism can manifest by a myriad of clinical symptoms. High grade fever is a rare presentation of thromboembolic phenomenon. PATIENT CONCERNS: A middle aged woman presented with high grade fevers. DIAGNOSES: Patient remained febrile despite broad spectrum antibiotics. All cultures were negative. CT angiogram of the chest was done, eliciting a large saddle embolus. INTERVENTIONS: Intravenous tissue plasminogen activator (t-PA) was administered and subsequently started on anticoagulation. Patient became afebrile 3 days after initiation of anticoagulation and all antibiotics were discontinued. OUTCOMES: We demonstrate a case of a saddle pulmonary embolism presenting with high grade fevers that responded to anticoagulation. LESSONS: It is imperative to include pulmonary embolism in the differential diagnosis, when presented with high-grade fever in patients with unclear diagnosis.
[Mh] Termos MeSH primário: Febre/etiologia
Fibrinolíticos/uso terapêutico
Embolia Pulmonar/diagnóstico por imagem
Embolia Pulmonar/tratamento farmacológico
Ativador de Plasminogênio Tecidual/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Angiografia por Tomografia Computadorizada
Feminino
Seres Humanos
Tromboembolia Venosa/diagnóstico por imagem
Tromboembolia Venosa/tratamento farmacológico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Fibrinolytic Agents); EC 3.4.21.68 (Tissue Plasminogen Activator)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180301
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000010002


  5 / 17190 MEDLINE  
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[PMID]:28465460
[Au] Autor:Menjot de Champfleur N; Saver JL; Goyal M; Jahan R; Diener HC; Bonafe A; Levy EI; Pereira VM; Cognard C; Yavagal DR; Albers GW
[Ad] Endereço:From the Stanford Stroke Center, Department of Neurology and Neurological Sciences, Stanford University School of Medicine, CA (G.W.A.); Department of Radiology (M.G.) and Department of Clinical Neurosciences (M.G.), University of Calgary, Alberta, Canada; Division of Interventional Neuroradiology (
[Ti] Título:Efficacy of Stent-Retriever Thrombectomy in Magnetic Resonance Imaging Versus Computed Tomographic Perfusion-Selected Patients in SWIFT PRIME Trial (Solitaire FR With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke).
[So] Source:Stroke;48(6):1560-1566, 2017 06.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: The majority of patients enrolled in SWIFT PRIME trial (Solitaire FR With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke) had computed tomographic perfusion (CTP) imaging before randomization; 34 patients were randomized after magnetic resonance imaging (MRI). METHODS: Patients with middle cerebral artery and distal carotid occlusions were randomized to treatment with tPA (tissue-type plasminogen activator) alone or tPA+stentriever thrombectomy. The primary outcome was the distribution of the modified Rankin Scale score at 90 days. Patients with the target mismatch profile for enrollment were identified on MRI and CTP. RESULTS: MRI selection was performed in 34 patients; CTP in 139 patients. Baseline National Institutes of Health Stroke Scale score was 17 in both groups. Target mismatch profile was present in 95% (MRI) versus 83% (CTP). A higher percentage of the MRI group was transferred from an outside hospital ( =0.02), and therefore, the time from stroke onset to randomization was longer in the MRI group ( =0.003). Time from emergency room arrival to randomization did not differ in CTP versus MRI-selected patients. Baseline ischemic core volumes were similar in both groups. Reperfusion rates (>90%/TICI [Thrombolysis in Cerebral Infarction] score 3) did not differ in the stentriever-treated patients in the MRI versus CTP groups. The primary efficacy analysis (90-day mRS score) demonstrated a statistically significant benefit in both subgroups (MRI, =0.02; CTP, =0.01). Infarct growth was reduced in the stentriever-treated group in both MRI and CTP groups. CONCLUSIONS: Time to randomization was significantly longer in MRI-selected patients; however, site arrival to randomization times were not prolonged, and the benefits of endovascular therapy were similar. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01657461.
[Mh] Termos MeSH primário: Isquemia Encefálica/diagnóstico por imagem
Isquemia Encefálica/terapia
Circulação Cerebrovascular
Imagem de Difusão por Ressonância Magnética/métodos
Fibrinolíticos/uso terapêutico
Avaliação de Processos e Resultados (Cuidados de Saúde)
Stents
Acidente Vascular Cerebral/diagnóstico por imagem
Acidente Vascular Cerebral/terapia
Trombectomia/métodos
Ativador de Plasminogênio Tecidual/uso terapêutico
Tomografia Computadorizada por Raios X/métodos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Isquemia Encefálica/etiologia
Doenças das Artérias Carótidas/complicações
Terapia Combinada
Feminino
Seres Humanos
Infarto da Artéria Cerebral Média/complicações
Masculino
Meia-Idade
Método Simples-Cego
Acidente Vascular Cerebral/etiologia
Fatores de Tempo
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Fibrinolytic Agents); EC 3.4.21.68 (Tissue Plasminogen Activator)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.117.016669


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[PMID]:29269698
[Au] Autor:Nakanishi K; Kawano H; Amano T; Omori Y; Kanma H; Hirano T
[Ad] Endereço:Department of Stroke and Cerebrovascular Medicine, Kyorin University.
[Ti] Título:[Stroke due to infective endocarditis diagnosed by the retrieved thrombus: a case report].
[So] Source:Rinsho Shinkeigaku;58(1):35-40, 2018 Jan 26.
[Is] ISSN:1882-0654
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:A 80-years-old woman suddenly presented with aphasia, right hemiparesis, and dysesthesia. MRA showed the left middle cerebral artery occlusion. She was diagnosed as hyperacute ischemic stroke. She was treated with intravenous recombinant tissue plasminogen activator and underwent endovascular thrombectomy. On admission, she had a fever and high C reactive protein, and was treated with antibiotic therapy. The pathological diagnosis of the retrieved thrombus revealed the cluster of the gram positive cocci. The blood culture was negative and thransthoracic echocardiogram did not detect the vegetation. She was finally diagnosed as cardioembolic stroke due to infective endocarditis based on the pathological diagnosis of the retrieved thrombus. The pathological diagnosis of the retrieved thrombus was quite important to clarify the cause of ischemic stroke.
[Mh] Termos MeSH primário: Endocardite/complicações
Endocardite/diagnóstico
Procedimentos Endovasculares/métodos
Infecções por Bactérias Gram-Positivas
Acidente Vascular Cerebral/etiologia
Acidente Vascular Cerebral/terapia
Trombectomia/métodos
Trombose/complicações
Trombose/microbiologia
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Endocardite/microbiologia
Endocardite/patologia
Feminino
Cocos Gram-Positivos
Seres Humanos
Infusões Intravenosas
Angiografia por Ressonância Magnética
Acidente Vascular Cerebral/diagnóstico por imagem
Trombose/patologia
Ativador de Plasminogênio Tecidual/administração & dosagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
EC 3.4.21.68 (Tissue Plasminogen Activator)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171223
[St] Status:MEDLINE
[do] DOI:10.5692/clinicalneurol.cn-001099


  7 / 17190 MEDLINE  
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[PMID]:28459065
[Au] Autor:Keric N; Masomi-Bornwasser J; Müller-Werkmeister H; Kantelhardt SR; König J; Kempski O; Giese A
[Ad] Endereço:Department of Neurosurgery, University Medical Center, Johannes Gutenberg University, Mainz, Germany.
[Ti] Título:Optimization of Catheter Based rtPA Thrombolysis in a Novel In Vitro Clot Model for Intracerebral Hemorrhage.
[So] Source:Biomed Res Int;2017:5472936, 2017.
[Is] ISSN:2314-6141
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Hematoma lysis with recombinant tissue plasminogen activator (rtPA) has emerged as an alternative therapy for spontaneous intracerebral hemorrhage (ICH). Optimal dose and schedule are still unclear. The aim of this study was to create a reliable in vitro blood clot model for investigation of optimal drug dose and timing. An in vitro clot model was established, using 25 mL and 50 mL of human blood. Catheters were placed into the clots and three groups, using intraclot application of rtPA, placebo, and catheter alone, were analyzed. Dose-response relationship, repetition, and duration of rtPA treatment and its effectiveness in aged clots were investigated. A significant relative end weight difference was found in rtPA treated clots compared to catheter alone ( = 0.002) and placebo treated clots ( < 0.001). Dose-response analysis revealed 95% effective dose around 1 mg rtPA in 25 and 50 mL clots. Approximately 80% of relative clot lysis could be achieved after 15 min incubation. Lysis of aged clots was less effective. A new clot model for in vitro investigation was established. Our data suggest that current protocols for rtPA based ICH therapy may be optimized by using less rtPA at shorter incubation times.
[Mh] Termos MeSH primário: Hemorragia Cerebral
Fibrinólise/efeitos dos fármacos
Modelos Biológicos
Terapia Trombolítica/métodos
Trombose/tratamento farmacológico
Ativador de Plasminogênio Tecidual
[Mh] Termos MeSH secundário: Cateteres
Hemorragia Cerebral/fisiopatologia
Hemorragia Cerebral/terapia
Relação Dose-Resposta a Droga
Seres Humanos
Ativador de Plasminogênio Tecidual/farmacologia
Ativador de Plasminogênio Tecidual/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
EC 3.4.21.68 (Tissue Plasminogen Activator)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.1155/2017/5472936


  8 / 17190 MEDLINE  
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[PMID]:29304073
[Au] Autor:Saito J; Yokoyama U; Nicho N; Zheng YW; Ichikawa Y; Ito S; Umemura M; Fujita T; Ito S; Taniguchi H; Asou T; Masuda M; Ishikawa Y
[Ad] Endereço:Cardiovascular Research Institute, Yokohama City University, Yokohama, Japan.
[Ti] Título:Tissue-type plasminogen activator contributes to remodeling of the rat ductus arteriosus.
[So] Source:PLoS One;13(1):e0190871, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:AIMS: The ductus arteriosus (DA) closes after birth to adapt to the robust changes in hemodynamics, which require intimal thickening (IT) to occur. The smooth muscle cells of the DA have been reported to play important roles in IT formation. However, the roles of the endothelial cells (ECs) have not been fully investigated. We herein focused on tissue-type plasminogen activator (t-PA), which is a DA EC dominant gene, and investigated its contribution to IT formation in the DA. METHODS AND RESULTS: ECs from the DA and aorta were isolated from fetal rats using fluorescence-activated cell sorting. RT-PCR showed that the t-PA mRNA expression level was 2.7-fold higher in DA ECs than in aortic ECs from full-term rat fetuses (gestational day 21). A strong immunoreaction for t-PA was detected in pre-term and full-term rat DA ECs. t-PA-mediated plasminogen-plasmin conversion activates gelatinase matrix metalloproteinases (MMPs). Gelatin zymography revealed that plasminogen supplementation significantly promoted activation of the elastolytic enzyme MMP-2 in rat DA ECs. In situ zymography demonstrated that marked gelatinase activity was observed at the site of disruption in the internal elastic laminae (IEL) in full-term rat DA. In a three-dimensional vascular model, EC-mediated plasminogen-plasmin conversion augmented the IEL disruption. In vivo administration of plasminogen to pre-term rat fetuses (gestational day 19), in which IT is poorly formed, promoted IEL disruption accompanied by gelatinase activation and enhanced IT formation in the DA. Additionally, experiments using five human DA tissues demonstrated that the t-PA expression level was 3.7-fold higher in the IT area than in the tunica media. t-PA protein expression and gelatinase activity were also detected in the IT area of the human DAs. CONCLUSION: t-PA expressed in ECs may help to form IT of the DA via activation of MMP-2 and disruption of IEL.
[Mh] Termos MeSH primário: Canal Arterial/patologia
Ativador de Plasminogênio Tecidual/fisiologia
[Mh] Termos MeSH secundário: Animais
Canal Arterial/enzimologia
Células Endoteliais/metabolismo
Feminino
Gelatinases/metabolismo
Células Endoteliais da Veia Umbilical Humana
Seres Humanos
Metaloproteinases da Matriz/metabolismo
Plasminogênio/administração & dosagem
Gravidez
Interferência de RNA
Ratos
Ratos Wistar
Reação em Cadeia da Polimerase Via Transcriptase Reversa
Ativador de Plasminogênio Tecidual/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
9001-91-6 (Plasminogen); EC 3.4.21.68 (Tissue Plasminogen Activator); EC 3.4.24.- (Gelatinases); EC 3.4.24.- (Matrix Metalloproteinases)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180106
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190871


  9 / 17190 MEDLINE  
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[PMID]:29328636
[Au] Autor:Komatina N; Lepic T; Labovic B; Stevovic T; Petronijevic M; Radovinovic-Tasic S; Obradovic D
[Ti] Título:Relapse of Takayasu arteritis as a cause of suicidal poisoning and subsequent major ischemic stroke successfully treated with thrombolytic therapy.
[So] Source:Vojnosanit Pregl;73(8):788-92, 2016 Aug.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Introduction: Takayasu arteritis (TA) is a rare large vessel arteritis, affecting primarily aorta and its major branches. Its clinical manifestations can vary significantly - from asymptomatic to serious vascular events. Acute neurological complications are frequent at the onset of the disease and in relapses. Anxiety and depression are more frequent in TA patients than in general population as well as during relapses. Prevalence of transient ischemic attack or ischemic stroke in TA patients is approximately 10-20%. Case report: We presented a patient with TA that began with a depressive episode resulting in attempted suicide by bromazepame poisoning. This was subsequently followed by major ischemic stroke caused by thrombosis of the left middle cerebral artery (probably due to aortic arch embolism) successfully treated with intravenous thrombolysis. Conclusion: Intravenous thrombolysis appears to be safe and effective in patients with TA and stroke.
[Mh] Termos MeSH primário: Ansiolíticos/envenenamento
Isquemia Encefálica/induzido quimicamente
Isquemia Encefálica/terapia
Bromazepam/envenenamento
Tentativa de Suicídio
Arterite de Takayasu/psicologia
Terapia Trombolítica
[Mh] Termos MeSH secundário: Depressão/etiologia
Feminino
Fibrinolíticos/uso terapêutico
Seres Humanos
Meia-Idade
Recidiva
Terapia Trombolítica/métodos
Ativador de Plasminogênio Tecidual/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Anxiety Agents); 0 (Fibrinolytic Agents); EC 3.4.21.68 (Tissue Plasminogen Activator); X015L14V0O (Bromazepam)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180113
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150717092K


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[PMID]:29390574
[Au] Autor:Rota E; Bruzzone G; Agosti S; Pastorino R; Morelli N
[Ad] Endereço:Neurology Unit.
[Ti] Título:A case report of parenchymal hematoma after intravenous thrombolysis in a rivaroxaban-treated patient: Is it a true rivaroxaban hemorrhagic complication?
[So] Source:Medicine (Baltimore);96(51):e9435, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: To date, the only treatment approved for acute ischemic strokes is thrombolysis. Whether intravenous thrombolysis may be safe in patients taking direct oral anticoagulants (DOACs) is currently a matter of debate. PATIENT CONCERNS: A 74-year-old woman, who was on rivaroxaban 20 mg/d for nonvalvular atrial fibrillation, was admitted to our stroke unit with left-sided hemiparesis and aphasia. The onset of neurologic deficits had occurred 5 hours after the last rivaroxaban dose. DIAGNOSIS: An acute ischemic stroke was diagnosed. INTERVENTIONS: The patient was administered thrombolytic treatment with intravenous recombinant tissue plasminogen activator (r-TPA) 3 hours and 20 minutes after symptoms onset. Seven hours post-r-TPA treatment, the neurological deficit had worsened, and a type I intraparenchymal hematoma was detected on a computed tomography brain scan. OUTCOMES: The clinical/neuroradiological picture improved significantly in the following days. The patient was discharged to a rehabilitation facility after 3 weeks. LESSONS: In this case, factor ten activated (Xa) inhibitor, rivaroxaban might have increased the risk of hemorrhagic transformation of the ischemic stroke. However, this risk was overweighed by the benefit of thrombolysis, as the patient's clinical condition had improved significantly in the following weeks. The current guidelines discourage the use of thrombolytic treatment in patients with DOACs administered within the last 24(48) hours. However, the case reported herein and other world experiences, even though limited, suggest that an ongoing DOAC medication could no longer be considered a barrier to r-TPA treatment which may be a reasonable and valuable option, at least in selected acute stroke patients taking factor Xa inhibitors.
[Mh] Termos MeSH primário: Inibidores do Fator Xa/efeitos adversos
Hematoma Subdural Intracraniano/induzido quimicamente
Rivaroxabana/efeitos adversos
Acidente Vascular Cerebral/tratamento farmacológico
Terapia Trombolítica/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Inibidores do Fator Xa/uso terapêutico
Feminino
Seres Humanos
Proteínas Recombinantes
Rivaroxabana/uso terapêutico
Terapia Trombolítica/métodos
Ativador de Plasminogênio Tecidual/efeitos adversos
Ativador de Plasminogênio Tecidual/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Factor Xa Inhibitors); 0 (Recombinant Proteins); 9NDF7JZ4M3 (Rivaroxaban); EC 3.4.21.68 (Tissue Plasminogen Activator)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009435



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