10 research outputs found

    Low-dose versus standard-dose tissue plasminogen activator for intravenous thrombolysis in asian acute ischemic stroke patients

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    10.1161/STROKEAHA.110.582403Stroke418e545-e546SJCC

    Letter by Ng et al regarding article, risk of early carotid endarterectomy for symptomatic carotid stenosis

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    10.1161/STROKEAHA.110.605410Stroke424e359-SJCC

    Intravenous thrombolysis for acute ischemic stroke in Asia

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    10.1586/ern.11.148Expert Review of Neurotherapeutics122209-217ERNX

    Muscle atrophy in mechanically-ventilated critically ill children

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    10.1371/journal.pone.0207720PLoS ONE1312e020772

    EMLA-induced skin wrinkling for the detection of diabetic neuropathy

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    10.3389/fneur.2013.00126Frontiers in Neurology43712Article 12

    Current status of intravenous thrombolysis for acute ischemic stroke in Asia

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    Background Data regarding thrombolysis for acute ischemic stroke in Asia are scarce and only a small percentage of patients are thrombolysed. The dose of intravenous tissue plasminogen activator (IV-tPA) in Asia remains controversial. Case-controlled observation studies in Asia included only Japanese patients and suggested the clinical efficacy and safety of low-dose IV-tPA (0·6mg/kg body weight; max 60mg) comparable to standard dose (0·9mg/kg body weight; max. 90mg). Reduced treatment cost, lower symptomatic intracerebral hemorrhage risk and comparable efficacy encouraged many Asian centers to adopt low-dose or even variable-dose IV-tPA regimens. We evaluated various Asian thrombolysis studies and compared with SITS-MOST registry and NINDS trial. Methods We included the published studies on acute ischemic stroke thrombolysis in Asia. Unadjusted relative risks and 95% Confidence intervals were calculated for each study. Pooled estimates from random effects models were used because the tests for heterogeneity were significant. Results We found only 18 publications regarding acute ischemic stroke thrombolysis in Asia that included total of 9300 patients. Owing to ethnic differences, stroke severity, small number of cases in individual reports, outcome measures and tPA dose regimes, it is difficult to compare these studies. Functional outcomes were almost similar (to Japanese studies) when lower-dose IV-tPA was used in non-Japanese populations across Asia. Interestingly, with standard dose IV-tPA, considerably better functional outcomes were observed, without increasing symptomatic intracerebral hemorrhage rates. Conclusions Variable dose regimens of IV-tPA are used across Asia without any reliable or established evidence. Establishing a uniform IV-tPA regimen is essential since the rapid improvements in health-care facilities and public awareness are expected to increase the rates of thrombolysis in Asia. © 2011 The Authors. International Journal of Stroke © 2011 World Stroke Organization
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