Refimprove date January 2009 Thrombolysis is the breakdown lysis of thrombosis blood clots ref DorlandsDict eight 000108543 thrombolysis ref by pharmacology pharmacological means. It is colloquially referred to as clot busting for this reason. It works by stimulating fibrinolysis by plasmin through infusion of analogs of tissue plasminogen activator tPA , the protein that normally activates plasmin. Agents Thrombolysis suggests the use of thrombolytic drug s, which are either derived from Streptococcus species, or, more recently, using Recombinant DNA recombinant Biotechnology Pharmaceutical products biotechnology whereby tPA is manufactured by bacteria , resulting in a recombinant tissue plasminogen activator or rtPA. Some commonly used thrombolytics are streptokinase urokinase Recombinant tissue plasminogen activator s alteplase rtPA reteplase tenecteplase Principles Formation of blood clots lies at the basis of a number of serious diseases see below . By breaking down the clot, the disease process can be arrested, or the complications reduced. While other anticoagulant s such as heparin decrease the growth of a clot, thrombolytic agents actively reduce the size of the clot. Most thrombolytic agents work by activating the enzyme plasminogen , which clears the cross linked fibrin ... enzymes, and restores blood flow over occluded blood vessel s. Uses Diseases where thrombolysis is used ... JM, Zoppo G, Yamaguchi T, Berge E editor1 last Wardlaw editor1 first Joanna M title Thrombolysis for acute ... unfractionated or low molecular weight heparin , usually for 24 48 hours. Thrombolysis is usually intravenous . It may also be used during an angiogram intra arterial thrombolysis , e.g. when patients present with stroke beyond three hours. Thrombolysis is performed by many types of medical specialists ... thrombolysis fibrinolysis may be initiated by the emergency care practitioner . Emergency Care Practitioners ... thrombolysis is always the result of a risk benefit calculation of the heart attack, thrombolysis ... more details
Ultrasound Enhanced Systemic Thrombolysis is a medical technology that utilizes Transcranial doppler transcranial doppler ultrasonography to treat stroke causing blood clots. It is thought that Transcranial doppler transcranial doppler ultrasonography aimed at residual obstructive intracranial blood flow may help expose thrombi to tissue plasminogen activator or other Thrombolytic drug thrombolytic drugs . Studies have shown that complete recanalisation or dramatic clinical recovery can be increased by more than 19 when using Transcranial doppler transcranial doppler ultrasonography . See also Ultrasound Stroke Tissue plasminogen activator External links http content.nejm.org cgi content short 351 21 2170 Ultrasound Enhanced Systemic Thrombolysis for Acute Ischemic Stroke NEJM http www.thedoctorslounge.net neurology articles ultrasound stroke index.htm Ultrasound Enhanced Systemic Thrombolysis for Acute Ischemic Stroke http www.thedoctorslounge.net thedoctorslounge.net http www.druginfozone.nhs.uk Record 20Viewing viewRecord.aspx?id 541186 Ultrasound enhanced systemic thrombolysis for acute ischaemic stroke http www.druginfozone.nhs.uk druginfozone.nhs.uk http jon.sagepub.com cgi content abstract 14 2 108 CLOTBUST Design of a Randomized Trial of Ultrasound Enhanced Thrombolysis for Acute Ischemic Stroke http jon.sagepub.com sagepub.com http 64.37.123.165 trials TrialDetail.aspx?tid 452 Combined Lysis of Thrombus in Brain Ischemia with Transcranial Ultrasound and Systemic TPA http 64.37.123.165 Internet Stroke Center Category Medical treatments Category Ultrasound Category Medical ultrasound treatment stub ... more details
Thrombolytic drugs are used in medicine to dissolve thrombus blood clots in a procedure termed thrombolysis . They limit the damage caused by the blockage of the blood vessel . Uses Thrombolysis is used in myocardial infarction heart attack , Stroke Ischemic thromboembolic strokes , deep vein thrombosis and pulmonary embolism to clear a blocked artery and avoid permanent damage to the perfused see perfusion tissue e.g. myocardium , human brain brain , human leg leg and death . A less frequent use is to clear blocked catheter s that are used in long term medical therapy. Thrombolytic therapy in Stroke Hemorrhagic hemorrhagic stroke s is contraindicated , as its use in that situation would prolong bleeding into the intracranial space and cause further damage. Bleeding worksheet Members The thrombolytic drugs include tissue plasminogen activator t PA alteplase Activase reteplase Retavase tenecteplase TNKase anistreplase Eminase streptokinase Kabikinase , Streptase urokinase Abbokinase These drugs are most effective if administered immediately after it has been determined they are clinically appropriate. The advantage of administration is highest within the first sixty minutes, but may extend up to six hours after the start of symptoms. The drugs are often given in combination with intravenous heparin , or low molecular weight heparin , which are anticoagulant drug s. Side effects Hemorrhagic stroke is a rare but serious complication of thrombolytic therapy. If a patient has had thrombolysis before, an allergy against the thrombolytic drug may have developed especially after streptokinase . If the symptoms are mild, the infusion is stopped and the patient is commenced on an antihistamine before infusion is recommenced. Anaphylaxis generally requires immediate cessation of thrombolysis. See also thrombolysis anticoagulant drug s antiplatelet drug s antiaggregants References Reflist Antithrombotics Major Drug Groups DEFAULTSORT Thrombolytic Drug Category Drugs it Trombolitico ... more details
TNK is a three letter acronym that may refer to Hebrew Bible The Hebrew Bible. See also Tanakh . Tenecteplase TNK an enzyme used as a thrombolysis thrombolytic drug. TNK BP TNK BP Ltd. a Russian oil company. The Japanese animation studio TNK company TNK . TNK band TNK a Turkish band. The Beatles song Tomorrow Never Knows , the final track of The Beatles 1966 studio album Revolver . disambig de TNK fr TNK homonymie it TNK ja TNK ... more details
Duteplase is a plasminogen activator . ref name pmid8909909 cite journal author Malcolm AD, Keltai M, Walsh MJ title ESPRIT a European study of the prevention of reocclusion after initial thrombolysis with duteplase in acute myocardial infarction journal Eur. Heart J. volume 17 issue 10 pages 1522 31 year 1996 month October pmid 8909909 doi url http eurheartj.oxfordjournals.org cgi pmidlookup?view long&pmid 8909909 ref References reflist Antithrombotics Category Hematology blood drug stub ... more details
Orphan date January 2011 Frans Van de Werf Medical doctor MD , PhD and fellow of the European Society of Cardiology FESC , the American College of Cardiology ACC and the American Heart Association FAHA is a Belgian cardiologist at the University Hospital Leuven and a professor of medicine at the Katholieke Universiteit Leuven . He is chair of the university hospital s cardiovascular medicine department. ref European Perspectives. http circ.ahajournals.org cgi reprint 118 12 f67 Circulation . 2008 118 f67 f72 , doi 10.1161 CIRCULATIONAHA.108.190537. ref His research is focused on acute coronary syndrome s, thrombolysis and antithrombotic treatment. His doctoral thesis was an early treatise on the mechanism underlying the gallop rhythm in heart failure . Later, he collaborated in Leuven with D sir Collen to discover the clinical application of tissue plasminogen activator tPA . Professor Van de Werf is Editor in Chief of the European Heart Journal and is a member of the editorial boards of Circulation journal Circulation , International Journal of Cardiology , Coronary artery disease , Journal of Thrombosis and Thrombolysis . ref http www.f1000medicine.com member 1057354186860998 F1000 profile . Retrieved 30 March 2009. ref He was awarded the 2005 Joseph Maisin prize for 100000. Footnotes reflist Persondata Metadata see Wikipedia Persondata . NAME Van De Werf, Frans ALTERNATIVE NAMES SHORT DESCRIPTION cardiologist DATE OF BIRTH unknown PLACE OF BIRTH DATE OF DEATH PLACE OF DEATH Use dmy dates date March 2011 DEFAULTSORT Van De Werf, Frans Category Year of birth missing living people Category Living people Category Cardiologists Category Flemish academics ... more details
Multiple issues orphan June 2009 unreferenced June 2009 wikify December 2011 The Myocardial Ischaemia Audit Project MINAP previously known as the myocardial infarction National Audit Database began in late 1998 when a broadly based steering group developed a dataset for acute myocardial infarction AMI . This allowed clinicians to examine the management of myocardial infarction within their hospitals against targets specified by the National Service Framework for Coronary Heart Disease NSF . The audit project produces annual reports How the NHS manages heart attacks to show the performance of hospitals, ambulance services and cardiac networks in England and Wales against national standards and targets for the care of heart attack patients. MINAP has recently changed its name from the Myocardial Infarction National Audit Database to the Myocardial Ischaemia National Audit Project to reflect the importance of all acute coronary syndromes.Quarterly reports are available for hospitals, Strategic Health Authorities, and the Department of Health. MINAP provides thrombolysis data to the Healthcare Commission for their Annual Health Check. MINAP provides data to ambulance services to help monitor patient outcomes and support improvements in training and care delivery. MINAP also provides data to cardiac networks to support service improvement. MINAP is the first national audit to release annual reports showing hospital performance against NSF targets in the public domain which are available below. Sustained improvement of performance against NSF targets for thrombolysis and use of secondary prevention medication has been demonstrated since the end of 2000. Category National Health Service NHS stub ... more details
Infobox disease Name Intraocular hemorrhage Image Alt Caption DiseasesDB ICD10 ICD9 ICD9 360.43 ICDO OMIM MedlinePlus eMedicineSubj eMedicineTopic MeshID GeneReviewsID GeneReviewsName Intraocular hemorrhage sometimes hemophthalmos or hemophthalmia is bleeding hemorrhage into the human eye eye ball oculus in Latin . It may be the result of physical trauma direct injury to the eye or medical illness. Severe hemorrhage, particularly when leading to rising intraocular pressure pressure inside the eye , may lead to blindness . Types Subconjunctival hemorrhage under the conjunctiva Hyphema in the anterior chamber Vitreous hemorrhage into the vitreous humour vitreous Subretinal hemorrhage under the retina Submacular hemorrhage under the macula Causes Different causes may cause bleeding in different locations. Terson s syndrome as a result of subarachnoid hemorrhage Hemophilia a severe bleeding disorder, usually hereditary Anticoagulant s and thrombolysis medication to reduce blood clotting tendency or to disperse blood clots, respectively Eye pathology Category Medical emergencies Category Diseases of the eye and adnexa Category Injuries of head med stub ... more details
name Article 1 ref Treatment Thrombolysis allows for the treatment of ALI by dissolving the clot through the following methods Pharmacological thrombolysis In the past, streptokinase was the main thrombolytic ..., Thrombolysis in acute lower limb ischaemia, European Journal of Vascular Surgery, Volume 7, Issue ... Mar. 18, 2000 , pp. 764 767 ref Pharmacological thrombolysis requires a catheter insert into the affected .... ref name Article 11 Wardlaw, J.M., and C.P. Warlow. Thrombolysis in acute ischemic stroke does it work? STROKE Journal of the American Heart Association 23 1992 1826 1839. ref Mechanical Thrombolysis Another type of thrombolysis disrupts the clot mechanically using either saline jets or, more recently ... more details
inhibitor potentiates tissue type plasminogen activator induced thrombolysis in a rabbit jugular vein thrombolysis model journal Thromb. Res. volume 98 issue 4 pages 333 42 year 2000 month May ... br Thrombolysis br Cancer research br DEFAULTSORT Potato Carboxypeptidase Inhibitor Category Protease ... more details
Drugbox verifiedrevid 464387412 IUPAC name image Clinical data tradename pregnancy AU A B1 B2 B3 C D X pregnancy US A B C D X pregnancy category legal AU Unscheduled S2 S3 S4 S5 S6 S7 S8 S9 legal CA Schedule I, II, III, IV, V, VI, VII, VIII legal UK GSL P POM CD Class A, B, C legal US OTC Rx only Schedule I, II, III, IV, V legal status routes of administration Pharmacokinetic data bioavailability protein bound metabolism elimination half life excretion Identifiers CAS number Ref cascite correct ?? CAS number ATC prefix B01 ATC suffix AD08 PubChem DrugBank Ref drugbankcite correct drugbank DrugBank ChemSpiderID Ref chemspidercite correct chemspider ChemSpiderID NA Chemical data chemical formula molecular weight Saruplase is a fibrinolytic enzyme. ref name pmid10608024 cite journal author B r FW, Vermeer F, Michels R, et al. title Saruplase in Myocardial Infarction journal J. Thromb. Thrombolysis volume 2 issue 3 pages 195 204 year 1995 pmid 10608024 doi url ref It is closely related to urokinase . ref name pmid15992082 cite journal author Moser M, Bode C title Pharmacology and clinical trial results of saruplase scuPA in acute myocardial infarction journal Expert Opin Investig Drugs volume 8 issue 3 pages 329 35 year 1999 month March pmid 15992082 doi 10.1517 13543784.8.3.329 url ref References reflist External links MeshName Saruplase Antithrombotics Category Antithrombotic enzymes blood drug stub pt Saruplase ... more details
other options, such as catheter directed thrombolysis and anticoagulation with observation. ref cite ... Patel, Nikunj volume 99 issue 3 pages 421 423 pmid 17261411 ref See also Thrombolysis Heparin and other ... more details
Image hsecar.jpg thumb right 300px A HSE National Ambulance Service HSE emergency response car at Aviva Stadium , Dublin Advanced Paramedic AP is the highest clinical level level 6 in pre hospital care in Republic of Ireland Ireland based on the standards set down by PHECC , the Irish regulatory body for pre hospital care and ambulance services. Advanced Paramedics are employed within the statutory ambulance services the HSE National Ambulance Service and Dublin Fire Brigade working both on ambulance s and emergency response cars. Education and certification In order to be eligible for acceptance to the Advanced Paramedic upskilling programme, a candidate must be a practicing Paramedic PHECC level 5 employed within an ambulance service for a minimum of three years post qualification. The course is run in conjunction with the School of Medicine and Medical Science University College Dublin School of Medicine , University College Dublin . Successful candidates receive the National Qualification in Emergency Medical Technology Advanced NQEMTA from PHECC and the Graduate Diploma in Emergency Medical Technology GradDip.EMT from UCD. Upon receiving the qualification, Advanced Paramedics must then register with PHECC as level 6 practitioners in order to practice their skills. Scope of practice The Advanced Paramedic programme was introduced in 2004 in Ireland 2004 to provide pre hospital advanced life support as part of the ambulance service for the general public, thus increasing survival rates among critically ill injured patients. The programme is based on the various international EMT P programmes. The following is a list of just some of the skills in the AP scope of practice Endotracheal intubation Thrombolysis Administration of a large range of emergency medicine medications Intravenous cannulation and intraosseous infusion 12 lead ECG interpretation Needle cricothyrotomy Manual defibrillation See also Emergency medical technician Emergency physician External links h ... more details
the essential basis for the development of effective therapy of stroke, e. g. thrombolysis . Further ... with thrombolysis could be significantly reduced in the service area of the Cologne Department of Neurology ... more details
options include injection of an anticoagulant , thrombolysis , embolectomy , surgical revascularisation ... emboli may be treated with catheter directed thrombolysis using intraarterial infusion of a thrombolytic ... more details
, and stroke , in a medical treatment called thrombolysis . To be most effective in ischemic ... journal author Mateen FJ, Buchan AM, Hill MD, for the CASES investigators title Outcomes of thrombolysis ... approved for acute myocardial infarction , where it has more convenient administration and faster thrombolysis ... ref See also Thrombolysis Ultrasound Enhanced Systemic Thrombolysis Lyme disease References ... more details
support skills Full diagnostics assessment Thrombolysis On scene discharge South Africa ECP skills in South Africa include Full South African advanced life support skills Full diagnostics assessment Thrombolysis ... more details
also offers emergency stroke services with 24 hour availability for emergency Thrombolysis thrombolytic therapy of intra arterial or intravenous thrombolysis. It is equipped to treat infections of the brain ... more details
Drugbox verifiedrevid 457131584 IUPAC name Clinical data tradename Eminase Drugs.com drugs.com CONS anistreplase pregnancy category legal status routes of administration Pharmacokinetic data bioavailability protein bound metabolism elimination half life 90 minutes Identifiers CASNo Ref cascite CAS number Ref cascite correct ?? CAS number 81669 57 0 ATC prefix B01 ATC suffix AD03 ATC supplemental PubChem DrugBank Ref drugbankcite correct drugbank DrugBank DB00029 KEGG Ref keggcite correct kegg KEGG D02947 ChemSpiderID Ref chemspidercite correct chemspider ChemSpiderID NA Chemical data molecular weight approx. 131,000 g mol Anistreplase is a thrombolytic drug. ref name pmid8563585 cite journal author Rawles J title Magnitude of benefit from earlier thrombolytic treatment in acute myocardial infarction new evidence from Grampian region early anistreplase trial GREAT journal BMJ volume 312 issue 7025 pages 212 5 year 1996 month January pmid 8563585 pmc 2350007 doi url http bmj.com cgi pmidlookup?view long&pmid 8563585 ref ref name pmid7612317 cite journal author Hannaford P, Vincent R, Ferry S, Hirsch S, Kay C title Assessment of the practicality and safety of thrombolysis with anistreplase given by general practitioners journal Br J Gen Pract volume 45 issue 393 pages 175 9 year 1995 month April pmid 7612317 pmc 1239197 doi url ref ref name pmid8289038 cite journal author Rawles J, Light J title Loss of quality adjusted days as a trial endpoint effect of early thrombolytic treatment in suspected myocardial infarction. Grampion Region Early Anistreplase Trial GREAT journal J Epidemiol Community Health volume 47 issue 5 pages 377 381 year 1993 month October pmid 8289038 pmc 1059832 doi 10.1136 jech.47.5.377 url ref Anistreplase has been developed by Beecham pharmaceutical company Beecham as Eminase. It is also known as anisoylated plasminogen streptokinase activator complex APSAC Mechanism It is a complex of purified human plasminogen and bacterial streptokinase that has ... more details
Rashid Hospital in Arabic language Arabic lang ar is a 454 bed general medical surgical hospital in Dubai , the United Arab Emirates , and is a part of the Dubai Government Dubai Health Authority. Built in 1973, it is the city s second oldest hospital, and is located on the E 66 road United Arab Emirates Oud Metha Road adjacent to Dubai Creek . ref cite news last Ismail first Manal title Rashid Hospital a symbol of evolving healthcare url http www.thenational.ae news uae news health rashid hospital a symbol of evolving healthcare accessdate 10 November 2011 newspaper The National date 7 November 2011 ref The new Trauma Centre at the hospital was completed in mid 2006 after a 7 year period since it was proposed. It can handle 7 ambulances simultaneously. Responsibility for day to day running of the Trauma Centre was awarded to Interhealth Canada in 2007. The complex includes a medical library. In July 2006, the DOHMS now DHA announced a US 272 million AED1 billion plan to build a new 500 700 bed 30,000m2 hospital within available space in the current complex. The existing building will subsequently be demolished. The new hospital was expected to be ready by 2010 but to date 2011 there are no signs of any progress. Rashid Hospital s CEO is Dr Ahmed Shawqi Khoury, an Emirati consultant gastroenterologist . Until recently it was a hospital that provided free treatment to the populace and therefore was a magnet for Dubai s poor and needy. Following Dubai s recent economic hardships it is no longer free except for life saving emergency treatments such as thrombolysis for Acute Myocardial Infarction Heart Attacks . Coronary artery stent insertion is no longer free. Previously free procedures such as Appendectomy and Laparotomy now attract a significant fees, well out of the reach of Dubai s poor many of whom are uninsured. The Rashid Hospital Trauma Centre deals with some of the heaviest volume of major trauma in the world with on average 3 to 5 cases of severe ... more details
The Gruppo Italiano per lo Studio della Sopravvivenza nell Infarto Miocardico GISSI Italian group for the study of the survival of Myocardial Infarction is an influential cardiology research group founded as a collaboration between two Italian organisations the Mario Negri Institute and the Associazione Nazionale dei Medici Cardiologi Ospedalieri ANMCO . ref name GISSI http www.gissi.org EngIntro T Intro ENG.php GISSI Presentation Presentation Bot generated title ref The trials carried out by GISSI have obtained wide recognition in the international world of cardiology and are considered a methodological landmark ref name GISSI . Four large scale clinical trials over the past 20 years GISSI 1 ref cite journal author title Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Gruppo Italiano per lo Studio della Streptochinasi nell Infarto Miocardico GISSI journal Lancet volume 1 issue 8478 pages 397 402 year 1986 pmid 2868337 doi ref ref cite journal author title Long term effects of intravenous thrombolysis in acute myocardial infarction final report of the GISSI study. Gruppo Italiano per lo Studio della Streptochi nasi nell Infarto Miocardico GISSI journal Lancet volume 2 issue 8564 pages 871 4 year 1987 pmid 2889079 doi ref , GISSI 2 ref cite journal author title GISSI 2 a factorial randomised trial of alteplase versus streptokinase and heparin versus no heparin among 12,490 patients with acute myocardial infarction. Gruppo Italiano per lo Studio della Sopravvivenza nell Infarto Miocardico journal Lancet volume 336 issue 8707 pages 65 71 year 1990 pmid 1975321 doi ref ref cite journal author Theinternationalstudygroup, title In hospital mortality and clinical course of 20,891 patients with suspected acute myocardial infarction randomised between alteplase and streptokinase with or without heparin. The International Study Group journal Lancet volume 336 issue 8707 pages 71 5 year 1990 pmid 1975322 doi 10.1016 0140 6736 90 91590 7 ref ... more details
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