Objective: The safety and efficacy of treatment with IV-rtPA between 4.5-6 hours after onset is unclear. Similarly there is little data on outcome of patients treated with rtPA with normal or low NIHSS. Background: Stroke in China is the leading cause of death. We report on a collaboration between a large metropolitan hospital in China, Tianjin Huanhu Hospital, and Inova Fairfax and Alexandria Stroke Programs presenting data on the first 1000 (of more than 3300 treated since 2012) patients treated with IV-rtPA. Methods: Patients were treated with thrombolysis between late 2012 and fall of 2014. Patients had MRI scans at 24 hours. Patients had NIHSS scores before and after treatment, and modified Rankin Scores (mRS) at 90 days after treatment. Results: There was not a significant correlation between onset to treatment times up to 6 hours, and mRS at 90 days (while controlling for baseline NIHSS). Thus, those with longer treatment times did not do worse. Eight-five [percnt] of patients treated beyond 4.5 hours had excellent outcomes. Many of these patients had NIHSS scores <5. Conclusions: 1) IV-rtPA can be given safely between 4.5-6 hours without significant risk of sICH and worsening outcomes. 2) Higher NIHSS before thrombolysis was correlated with poorer outcomes. 3) There was no significant correlation between onset to treatment time up to 6 hours and outcome. 4) Outcome was excellent (mRS 0-1) in 72[percnt] treated 0-3 hours, 74[percnt] 3-4.5 hours and remarkably 85[percnt] 4.5-6 hours. Comment: This cohort represents one of the largest series of acute stroke patients treated with IV-rtPA > 4.5 hours after onset. It also reveals outcome of treatment in patients with low NIHSS treated at various intervals after last know well.
This article has been retracted, and the online PDF has been watermarked “RETRACTION”. The retraction notice is available at http://doi.org/10.3233/MGC-220950.
This article introduces the structure, principle and characteristics of a new anorectal therapeutic apparatus. The adoption of new technologies, new components and new materials lays the foundation for the compatibility for electric energy, magnetic energy and thermal energy as well as the safety and comfortability of the intracavitary electrode. The intracavitary electrode possesses the functions of electrotherapy, thermotherapy, magnetotherapy and massage, and thus can be applied to the physical therapies of colitis, irritable bowel syndrome and prostatitis. The apparatus has such advantages as reliable curative effects, no toxic and side effects, simple manipulations, low cost, etc, and thus should be popularized.
OBJECTIVE: To evaluate the safe - ty and efficacy of urinary kallidinogenase for recombinant tissue-type plasminogen activator (rt-PA) intravenous thrombolytic treatment in patients with acute cerebral infarction. PATIENTS AND METHODS: All 200 patients with acute cerebral infarction were randomized 1:1 into an experimental group (100 cases) and a control group (100 cases). Patients in the control groupwere administrated rt-PA (0/9 mg/kg) while patients in the experimental group were given urinary kallidinogenase by intravenous drip (0.15 PNAU/d, for 7 days) after rt-PA intravenous thrombolytic treatment (0.9 mg/kg). The main evaluation index was NIHSS and BI. RESULTS: Compared to the control group, the NIHSS scores were significantly lower 7 and 90 days after thrombolytic therapy ( t = 2.391, 2.714; p < 0.05). BI scores were obviously high - er at 90 days after thrombolytic therapy in the experimental group ( t = 2.675, p < 0.05). CONCLUSIONS: Urinary kallidinogenase may improve the treatment effect for rt-PA intra - venous thrombolytic treatment in patients with acute cerebral infraction.
Introduction: Stroke in China is the leading cause of death. We report on a collaboration between a large metropolitan hospital in China, Tianjin Huanhu Hospital, and Inova Fairfax and Inova Alexandria Stroke Programs presenting data on the first 1000 (of more than 3300 treated since 2012) patients treated with IV-rtPA. The safety and efficacy of treatment with rtPA between 4.5-6 hours after onset is unclear. Similarly there is little data on outcome of patients treated with rtPA with normal or low NIHSS. Methods: Patients were treated with thrombolysis between late 2012 and fall of 2014. Patients had MRI scans at 24 hours. Patients had NIHSS scores before and after treatment, and modified Rankin Scores (mRS) at 90 days after treatment. Results: See Chart. Conclusions: 1) IV-rtPA can be given safely between 4.5-6 hours without significant risk of sICH and worsening outcomes. 2) Higher NIHSS before thrombolysis was correlated with poorer outcomes. 3) There was no significant correlation between onset to treatment time up to 6 hours and outcome. 4) Outcome was excellent (mRS 0-1) in 72% treated 0-3 hours, 74% 3-4.5 hours and remarkably 85% 4.5-6 hours. The data set includes many patients who were asymptomatic or nearly so prior to treatment. This will need to be more fully evaluated in the remainder (2300) of this cohort of more than 3300 treated patients. Comment: This cohort represents one of the largest series of acute stroke patients treated with IV-rtPA > 4.5 hours after onset. It also reveals outcome of treatment in patients with low NIHSS treated at various intervals after last know well.
The aim of the study was to investigate the efficacy of homemade tolcapone in treatment of patients with Parkinson's disease (PD). Eighty patients with PD were subjected to randomized, double-blind, placebo-controlled and parallel-group study. PD patients were randomly divided into the tolcapone treatment group (41 cases) and placebo group (39 cases). Each patient received 1 pill of tolcapone or placebo, 3 times per day for 26 weeks. Efficacy was evaluated using the internationally used unified Parkinson's disease rating scale (UPDRS) scoring system for PD symptoms. After the treatment for 26 weeks, the cognitive function, tremor, muscle stiffness, voluntary movement and autonomic nerve symptoms were compared between the two groups using UPDRS scores. Compared with the placebo group, cognitive function, muscle stiffness and voluntary movement reduction were significantly improved in patients of the tolcapone group (P<0.05). However, no significant differences in UPDRS scores of autonomic nerve symptoms and tremor were found between two groups after treatment (P>0.05). Tolcapone, a catechol-O-methyl transferase (COMT) inhibitor, can improve the motor function of patients with PD, especially exercise and muscle stiffness. Tolcapone can also improve the cognitive function of patients.
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