Article
Pharmacology & Pharmacy
Kirstin Meiners, Prisca Hamm, Marcus Gutmann, Jan Niedens, Agnieszka Nowak-Krol, Salvador Pane, Tessa Luehmann
Summary: The study developed three polyethylene glycol (PEG)ylated tPA bioconjugates based on the recombinant human tPA drug Alteplase using site-specific conjugation strategies. These bioconjugates showed improved proteolytic activity, slower inhibition kinetics by PAI-1, and increased hydrodynamic size.
EUROPEAN JOURNAL OF PHARMACEUTICS AND BIOPHARMACEUTICS
(2023)
Article
Medicine, General & Internal
Jing Yuan, Minghui Li, Yang Liu, Xiaomo Xiong, Zhengbao Zhu, Fangyu Liu, Yong Wang, Wei Hu, Z. Kevin Lu, Renyu Liu, Jing Zhao
Summary: In China, prehospital delay in stroke patients is often lengthy. The Stroke 1-2-0 educational campaign was implemented to improve public awareness and prompt early response to stroke symptoms. This study found that the campaign was associated with reduced prehospital delay, increased rates of timely hospital arrival and ambulance utilization among ischemic stroke patients.
Article
Clinical Neurology
Mellanie Springer, Ran Bi, Lesli E. Skolarus, Chun Chieh Lin, James F. Burke
Summary: Acute stroke treatments are underutilized in the USA, with stroke preparedness playing a role in regional variation in tPA treatment rates. Intent to call EMS and stroke symptom recognition contribute modestly to the regional variation in tPA treatment.
CEREBROVASCULAR DISEASES
(2022)
Article
Neurosciences
Antoine Anfray, Camille Brodin, Antoine Drieu, Fanny Potzeha, Basile Dalarun, Veronique Agin, Denis Vivien, Cyrille Orset
Summary: The commercial form of rtPA has similar effects in promoting fibrinolysis and tissue reperfusion, with two-chains rtPA showing less efficiency compared to single chain rtPA, and associated with more severe blood brain barrier damage.
EXPERIMENTAL NEUROLOGY
(2021)
Article
Economics
Marcos Colla, Gilson Ditzel Santos, Gilson Adamczuk Oliveira, Renata Braga Berenguer de Vasconcelos
Summary: Research on ambulance response times for EMS calls has been conducted for decades, primarily in developed countries. However, there is limited scientific research on this topic in Brazil, a developing country, which mainly focuses on cities with a population of over one million. This highlights the need to extend research to small and medium-sized cities.
SOCIO-ECONOMIC PLANNING SCIENCES
(2023)
Article
Clinical Neurology
Jose G. Romano, Hannah Gardener, Iszet Campo-Bustillo, Yosef Khan, Sofie Tai, Nikesha Riley, Eric E. Smith, Ralph L. Sacco, Pooja Khatri, Heather M. Alger, Brian Mac Grory, Deepak Gulati, Navdeep S. Sangha, Jeffrey M. Craig, Karin E. Olds, Curtis G. Benesch, Adam G. Kelly, Scott S. Brehaut, Amit C. Kansara, Lee H. Schwamm
Summary: The study found that most patients with mild strokes had poor outcomes in the study. The primary outcome was a 90-day modified Rankin Scale score of 0 to 1, with secondary outcomes including good outcomes in the Barthel Index, Stroke Impact Scale-16, and European Quality of Life. Factors such as age, gender, race, and baseline NIHSS score were identified as predictors of worse outcomes.
Article
Biology
Matthieu Lepine, Sara Douceau, Gabrielle Devienne, Paul Prunotto, Sophie Lenoir, Caroline Regnauld, Elsa Pouettre, Juliette Piquet, Laurent Lebouvier, Yannick Hommet, Eric Maubert, Veronique Agin, Bertrand Lambolez, Bruno Cauli, Carine Ali, Denis Vivien
Summary: The study reveals that tPA released from cortical FS-PV interneurons in the central nervous system can reduce the density of PNNs by degrading CSPGs. This finding provides valuable insights into the control of brain plasticity.
Review
Biochemistry & Molecular Biology
Angela Godinez, Rashi Rajput, Nitin Chitranshi, Veer Gupta, Devaraj Basavarajappa, Samridhi Sharma, Yuyi You, Kanishka Pushpitha, Kunal Dhiman, Mehdi Mirzaei, Stuart Graham, Vivek Gupta
Summary: Neuroserpin is a crucial protein involved in neuronal development and various diseases, with mutations affecting its function and leading to pathological conditions. Understanding the alterations of neuroserpin and its cellular signaling networks is essential for studying its detrimental consequences and potential therapeutic targeting.
CELLULAR AND MOLECULAR LIFE SCIENCES
(2022)
Article
Immunology
Guangshuo Li, Yahui Hao, Chuanying Wang, Shang Wang, Yunyun Xiong, Xingquan Zhao
Summary: In this study, the relationship between neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) with in-hospital clinical outcomes in ischemic stroke patients treated with intravenous tissue plasminogen activator (IV tPA) was investigated. The results showed that NLR at 24 hours was associated with early neurological improvement (ENI), while NLR at 48 hours and LMR at 48 hours were closely related to favorable functional outcomes at discharge.
JOURNAL OF INFLAMMATION RESEARCH
(2022)
Article
Clinical Neurology
Erika Marulanda, Antonio Bustillo, Carolina M. Gutierrez, David Z. Rose, Angus Jameson, Hannah Gardener, Ayham Alkhachroum, Lili Zhou, Hao Ying, Chuanhui Dong, Dianne Foster, Ricardo Hanel, Brijesh Mehta, Maxim Mokin, Nils Mueller-Kronast, Mark Landreth, Charles Sand, Jose G. Romano, Tatjana Rundek, Negar Asdaghi, Ralph L. Sacco
Summary: This study evaluated the quality of ischemic stroke care in NC and SA stroke centers in Florida and found that NC centers performed better. These findings have important implications for stroke systems of care in Florida and support legislation updates requiring NC and removal of SA claims.
Article
Emergency Medicine
Julia Barbour, Patricia Hushen, George C. Newman, Jennifer Vidal
Summary: This study found that patients with an emergency medicine pharmacist as part of their stroke response team had significantly lower DTN times, with a higher proportion of cases meeting benchmark DTN times of less than 30 minutes and 45 minutes. Additionally, patients with pharmacist involvement had lower NIHSS scores at discharge.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2022)
Article
Multidisciplinary Sciences
Abbas Moghanizadeh, Fakhreddin Ashrafizadeh, Jaleh Varshosaz, Antoine Ferreira
Summary: The study indicates that increasing the static magnetic field intensity can accelerate drug delivery by magnetic nanoparticles carrying thrombolytic agents, leading to faster dissolution of clots.
SCIENTIFIC REPORTS
(2021)
Article
Biochemistry & Molecular Biology
Tao Peng, Keith Booher, Melanie R. Moody, Xing Yin, Jaroslaw Aronowski, David D. Mcpherson, Sean I. Savitz, Hyunggun Kim, Shao-Ling Huang
Summary: This study demonstrates that the combination therapy of Xe-loaded liposomes and rtPA provides enhanced therapeutic efficacy in stroke treatment, leading to decreased neuronal cell death and mitigation of hemorrhagic side effects associated with late rtPA treatment.
Article
Clinical Neurology
Seung-Jae Lee, Tae-Kyeong Lee, Bum-Tae Kim, Dong-Seong Shin
Summary: Thrombus migration (TM) occurs in about 19.5% of patients undergoing thrombectomy, with intravenous thrombolysis (IVT) and female sex being associated with TM. TM is also associated with better functional outcomes in patients, regardless of the angiographic outcomes.
WORLD NEUROSURGERY
(2021)
Article
Clinical Neurology
Karim Mahawish, John Gommans, Timothy Kleinig, Bhavesh Lallu, Alicia Tyson, Annemarei Ranta
Summary: The switch from alteplase to tenecteplase for stroke thrombolysis was successfully implemented with stakeholder endorsement. Patients treated with tenecteplase showed better clinical outcomes, shorter door-to-needle time, and similar complication rates compared to alteplase.
Article
Rehabilitation
Nneka L. Ifejika, Minal Bhadane, Chunyan C. Cai, Jeffrey N. Watkins, James C. Grotta
Summary: The study found that patients with hemorrhagic stroke, non-Medicare insurance, or lower discharge FIM score during the first IRF hospitalization are more likely to require a second IRF stay.
Article
Peripheral Vascular Disease
Georgios Tsivgoulis, Aristeidis H. Katsanos, Pitchaiah Mandava, Martin Kohrmann, Lauri Soinne, Andrew D. Barreto, Vijay K. Sharma, Robert Mikulik, Keith W. Muir, Travis Rothlisberger, James C. Grotta, Christopher R. Levi, Carlos A. Molina, Maher Saqqur, Dimitris Mavridis, Theodora Psaltopoulou, Milan R. Vosko, Jochen B. Fiebach, Else Charlotte Sandset, Thomas A. Kent, Anne W. Alexandrov, Peter D. Schellinger, Andrei Alexandrov
Summary: The study found that blood pressure excursions in patients with acute ischemic stroke treated with tPA were common and independently associated with adverse clinical outcomes.
JOURNAL OF HYPERTENSION
(2021)
Article
Clinical Neurology
Victor Lopez-Rivera, Sergio Salazar-Marioni, Rania Abdelkhaleq, Sean Savitz, Alexandra L. Czap, Yazan J. Alderazi, Peng R. Chen, James C. Grotta, Spiros L. Blackburn, Wesley Jones, Gary Spiegel, Mark J. Dannenbaum, Tzu-Ching Wu, Joseph Cochran, Dong H. Kim, Arthur L. Day, Grace Farquhar, Louise D. McCullough, Sunil A. Sheth
Summary: The study demonstrates that increasing endovascular stroke therapy (EVT) availability through the implementation of an integrated stroke system (ISS) decreases the time from stroke onset to EVT-performing hospital (EPH) arrival. Following the implementation of ISS, the proportion of patients undergoing interhospital transfer decreased. Results show that ISS implementation resulted in a reduction of treatment time, with comparable outcomes in quality metrics at high and low volume hospitals.
Article
Cell & Tissue Engineering
Muhammad E. Haque, Khader M. Hasan, Sarah George, Clark Sitton, Seth Boren, Octavio D. Arevalo, Farhaan Vahidy, Xu Zhang, Charles S. Cox, Susan Alderman, Jaroslaw Aronowski, James C. Grotta, Sean Savitz
Summary: The study demonstrates that bone marrow mononuclear cells (MNCs) can attenuate secondary degeneration and enhance recovery in stroke animal models. MRI imaging showed that treated patients with larger infarcts and higher stroke severity exhibited an increase in relative FA and no change in relative MD from 3 to 12 months, which was not observed in the nontreated group.
STEM CELLS TRANSLATIONAL MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Youngran Kim, Songmi Lee, Rania Abdelkhaleq, Victor Lopez-Rivera, Babak Navi, Hooman Kamel, Sean Savitz, Alexandra L. Czap, James C. Grotta, Louise D. McCullough, Trudy Millard Krause, Luca Giancardo, Farhaan S. Vahidy, Sunil A. Sheth
Summary: In statewide and national Medicare fee-for-service cohorts, the utilization of CTP in patients with AIS was low and most patients were evaluated at hospitals that did not perform CTP. These findings suggest a need for alternative screening methods for AIS recanalization therapies.
CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES
(2021)
Article
Clinical Neurology
Joseph P. Broderick, James C. Grotta, Andrew M. Naidech, Thorsten Steiner, Nikola Sprigg, Kazunori Toyoda, Dar Dowlatshahi, Andrew M. Demchuk, Magdy Selim, J. Mocco, Stephan Mayer
Summary: Research in the acute management of intracerebral hemorrhage (ICH) over the past 35 years has shown that early treatment to control bleeding and minimize brain injury is crucial. However, current medical and surgical interventions have not yet shown significant benefits in large-scale trials, emphasizing the need for further research and improvement in the delivery of ICH therapies for better outcomes.
Editorial Material
Clinical Neurology
Alexandra L. Czap, James C. Grotta
Summary: This Viewpoint discusses the challenges of using thrombolysis in patients with acute ischemic stroke who are on or have recently been treated with direct oral anticoagulants.
Article
Health Care Sciences & Services
Elizabeth Anne Noser, Jing Zhang, Mohammad Hossein Rahbar, Anjail Zarinah Sharrief, Andrew David Barreto, Sandi Shaw, James Charles Grotta, Sean Isaac Savitz, Nneka Lotea Ifejika
Summary: The Stomp Out Stroke initiative addressed social inequities in cerebrovascular health by identifying race- or ethnicity-specific health needs and providing appropriate screenings to minority populations. Through internet-based recruitment and in-person assessments, the project reached a significant number of individuals in the Houston area at increased risk of urban flooding and stroke.
JOURNAL OF MEDICAL INTERNET RESEARCH
(2021)
Editorial Material
Clinical Neurology
James C. Grotta
Article
Medicine, General & Internal
J. C. Grotta, J. Yamal, S. A. Parker, S. S. Rajan, N. R. Gonzales, W. J. Jones, A. W. Alexandrov, B. B. Navi, M. Nour, I Spokoyny, J. Mackey, D. Persse, A. P. Jacob, M. Wang, N. Singh, A. Alexandrov, M. E. Fink, J. L. Saver, J. English, N. Barazangi, P. L. Bratina, M. Gonzalez, B. D. Schimpf, K. Ackerson, C. Sherman, M. Lerario, S. Mir, J. Im, J. Z. Willey, D. Chiu, M. Eisshofer, J. Miller, D. Ornelas, J. P. Rhudy, K. M. Brown, B. M. Villareal, M. Gausche-Hill, N. Bosson, G. Gilbert, S. Q. Collins, K. Silnes, J. Volpi, V Misra, J. McCarthy, T. Flanagan, C. P. Rao, J. S. Kass, L. Griffin, N. Rangel-Gutierrez, E. Lechuga, J. Stephenson, K. Phan, Y. Sanders, E. A. Noser, R. Bowry
Summary: In patients eligible for t-PA, mobile stroke units (MSUs) showed better functional outcomes at 90 days compared to emergency medical services (EMS). Patients in the MSU group were more likely to achieve a modified Rankin scale score of 0 or 1 at 90 days.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Article
Clinical Neurology
Ritvij Bowry, Stephanie A. Parker, Patti Bratina, Noopur Singh, Jose-Miguel Yamal, Suja S. Rajan, Asha P. Jacob, Kenny Phan, Alexandra Czap, James C. Grotta
Summary: This study found that patients with intracerebral hemorrhage (ICH) who underwent baseline imaging within the first hour after symptom onset had a higher risk of hematoma enlargement (HE), making them a target for ultraearly hemostatic intervention.
Letter
Clinical Neurology
Hussein A. Zeineddine, Wen Li, Peeyush T. Kumar, Devin McBride, Ari Dienel, Glenda Torres, James Grotta, Jude Savarraj, Tiffany Chang, Huimahn A. Choi, Pramod Dash, Spiros Blackburn
Review
Clinical Neurology
Mojtaba Dayyani, Behnam Sadeghirad, James C. Grotta, Samira Zabihyan, Saba Ahmadvand, Yuting Wang, Gordon H. Guyatt, Sepideh Amin-Hanjani
Summary: Network meta-analysis showed that nimodipine and cilostazol were likely the most effective treatments in preventing morbidity and mortality in patients with aneurysmal subarachnoid hemorrhage. Clazosentan, nicardipine, fasudil, and magnesium showed beneficial effects on delayed cerebral ischemia and vasospasm but they were not found to reduce mortality or disability.
Review
Clinical Neurology
Babak B. Navi, Heinrich J. Audebert, Anne W. Alexandrov, Dominique A. Cadilhac, James C. Grotta
Summary: Mobile stroke units (MSUs) are specialized ambulances equipped to diagnose and treat acute stroke in prehospital settings. Recent clinical trials have shown that treatment aboard MSUs is safe and leads to improved functional outcomes. However, questions remain regarding the cost-effectiveness of MSUs, their utility in nonurban settings, and optimal infrastructure.
Article
Clinical Neurology
Joseph P. Broderick, Yasmin N. Aziz, Opeolu M. Adeoye, James C. Grotta, Andrew M. Naidech, Andrew D. Barreto, Colin P. Derdeyn, Heidi J. Sucharew, Jordan J. Elm, Pooja Khatri
Summary: Randomized clinical trials of acute stroke have resulted in significant progress in acute stroke therapy, but recruitment of participants remains challenging. In this article, the challenges in recruitment for acute stroke trials are discussed, along with potential solutions to expedite the identification of new treatments. These solutions include expanding the inclusion criteria, improving availability of study investigators, utilizing telemedicine, enhancing prehospital notification, simplifying study protocols, and educating physicians. Successful recruitment is crucial for advancing scientific knowledge and improving clinical outcomes for acute stroke patients.
