The Emergency Medicine Debate on tPA for Stroke: What Is Best for Our Patients? Efficacy in the First Three Hours

Miller, Joseph; Heitsch, Laura; Siket, Matthew S.; Schrock, Jon W.; Wira, Charles; Lewandowski, Christopher; Madsen, Tracy E.; Merck, Lisa H.; Wright, David W.

doi:10.1111/acem.12712

Cited by 6 publications

(2 citation statements)

References 29 publications

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“…In the modern reperfusion era, AIS treatment with tissue plasminogen activator (alteplase) within the first 3 hours of symptom onset, derived from the original National Institute of Neurological Disorders and Stroke alteplase trial 34 and trialist collaborative, 35 is the current standard of care 5 and has been approved by the US Food and Drug Administration since 1996. 36 Earlier administration correlates with a higher treatment effect. Alteplase also has become a standard of care for select patients within a 4.5-hour window of LKN.…”

Section: Drug/device: Ais Treatmentmentioning

confidence: 99%

Care of the Patient With Acute Ischemic Stroke (Prehospital and Acute Phase of Care): Update to the 2009 Comprehensive Nursing Care Scientific Statement: A Scientific Statement From the American Heart Association

Ashcraft¹,

Wilson²,

Nyström³

et al. 2021

Stroke

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The year 2020 was the year of the nurse, celebrating nurse scholarship, innovation, and leadership by promoting scientific nursing research, improving nursing practice, advancing nursing education, and providing leadership to influence health policy. As architects of stroke care, neuroscience nurses play a vital role in collaborating and coordinating care between multiple health professionals. Nurses improve accessibility and equity through telestroke, emergency medical services, and mobile stroke units and are integral to implementing education strategies by advocating and ensuring that patients and caregivers receive stroke education while safely transitioning through the health care system and to home. Stroke care is increasingly complex in the new reperfusion era, requiring nurses to participate in continuing education while attaining levels of competency in both the acute and recovery care process. Advanced practice nurses are taking the lead in many organizations, serving as prehospital providers on mobile stroke units, participating as members of the stroke response team, and directing stroke care protocols in the emergency department. This scientific statement is an update to the 2009 “Comprehensive Overview of Nursing and Interdisciplinary Care of the Acute Ischemic Stroke Patient.” The aim is to provide a comprehensive review of the scientific evidence on nursing care in the prehospital and hyperacute emergency hospital setting, arming nurses with the necessary tools to provide evidenced-based high-quality care.

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Section: Drug/device: Ais Treatmentmentioning

confidence: 99%

Care of the Patient With Acute Ischemic Stroke (Prehospital and Acute Phase of Care): Update to the 2009 Comprehensive Nursing Care Scientific Statement: A Scientific Statement From the American Heart Association

Ashcraft¹,

Wilson²,

Nyström³

et al. 2021

Stroke

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“…Tissue plasminogen activator (tPA), an extracellular serine protease, is abundantly expressed in the nervous system. tPA catalyzes the conversion of plasminogen to plasmin and regulates the fibrinolysis [3,4], thus having been used to treat embolic or thrombotic stroke in the clinic [5,6]. Interestingly, it has been shown that the expression of tPA is changed after peripheral nerve injury [2], and tPA is likely to be implicated in peripheral nerve regeneration [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

MiR-340 Regulates Fibrinolysis and Axon Regrowth Following Sciatic Nerve Injury

Zhang

Yuan

et al. 2016

Mol Neurobiol

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After peripheral nerve injury, the degenerative debris and inflammatory alterations at the injury site may block the elongation of regenerating axons to reach target organs. Tissue plasminogen activator (tPA), a serine protease, has a capability of degrading matrix molecules and cell adhesions. In this study, we found that either tPA or miR-340 was differentially expressed in the injured nerve after sciatic nerve injury, and that the expressions of tPA and miR-340 were negatively correlated to each other. Moreover, miR-340 and tPA were co-localized in sciatic nerve. miR-340 regulated tPA through direct targeting of the 3'-UTR of tPA. Functionally, over- or under-expression of miR-340 reduced or augmented the fibrinolytic activity and migration ability of cultured Schwann cells as well as tPA secretion from the cells, respectively. In rats with sciatic nerve crush injury, dysregulation of the miR-340 expression in the injury site affected the cell debris removal and axonal regrowth. Obviously, unlike many previous studies that investigate the functional impact of miRNAs on peripheral nerve regeneration in the perspective of miRNA regulation of neural cell behaviors, the present study focused on miRNA regulation of debris clearance, thus updating our understanding of the regulatory roles of miRNAs in peripheral nerve regeneration.

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Mobile Stroke Units—the Changing Face of Emergency Medicine Stroke Management

Wira

Aydin

2020

Curr Emerg Hosp Med Rep

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The Emergency Medicine Debate on tPA for Stroke: What Is Best for Our Patients? Efficacy in the First Three Hours

Cited by 6 publications

References 29 publications

Care of the Patient With Acute Ischemic Stroke (Prehospital and Acute Phase of Care): Update to the 2009 Comprehensive Nursing Care Scientific Statement: A Scientific Statement From the American Heart Association

Care of the Patient With Acute Ischemic Stroke (Prehospital and Acute Phase of Care): Update to the 2009 Comprehensive Nursing Care Scientific Statement: A Scientific Statement From the American Heart Association

MiR-340 Regulates Fibrinolysis and Axon Regrowth Following Sciatic Nerve Injury

Mobile Stroke Units—the Changing Face of Emergency Medicine Stroke Management

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