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  1. Article ; Online: A practice game changer: Impact of tenecteplase for acute ischemic stroke in a multicenter quality improvement project.

    Noh, Lydia / Pham, Felix / Haddad, Lara / Burkhard, Theresa / Paletz, Laurie / Pech, Marco / Lewis, Maya / Manoukian, Vicki / Schlick, Konrad H / Song, Shlee

    American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists

    2022  Volume 79, Issue 9, Page(s) e149–e153

    Abstract: Purpose: Tenecteplase is a thrombolytic that is more fibrin specific, has a longer half-life, and is easier to administer than alteplase for acute ischemic stroke (AIS). This article outlines the pharmacy experience and perspective on implementation of ... ...

    Abstract Purpose: Tenecteplase is a thrombolytic that is more fibrin specific, has a longer half-life, and is easier to administer than alteplase for acute ischemic stroke (AIS). This article outlines the pharmacy experience and perspective on implementation of tenecteplase as the treatment of choice for AIS.
    Summary: Tenecteplase has been of increasing interest for AIS and is currently being studied in several clinical trials. Although it is not indicated by the Food and Drug Administration for AIS, several published studies and an update to stroke guidelines from the American Heart Association and American Stroke Association support its use in this setting. In January 2021, Cedars-Sinai Health System made the decision to add tenecteplase to the formulary for AIS in addition to keeping alteplase for patients who met the criterion of being outside the 4.5-hour window following stroke onset. Along with the added benefits of having tenecteplase on formulary come challenges of managing multiple thrombolytics for the same indication. Identifying key stakeholders and creating an interdisciplinary team are critical to ensure safe transitions.
    Conclusion: Institutions can safely transition from alteplase to tenecteplase as a thrombolytic of choice for AIS.
    MeSH term(s) Brain Ischemia/drug therapy ; Fibrinolytic Agents/therapeutic use ; Humans ; Ischemic Stroke ; Quality Improvement ; Stroke/drug therapy ; Tenecteplase/therapeutic use ; Tissue Plasminogen Activator/therapeutic use ; Treatment Outcome
    Chemical Substances Fibrinolytic Agents ; Tissue Plasminogen Activator (EC 3.4.21.68) ; Tenecteplase (WGD229O42W)
    Language English
    Publishing date 2022-01-10
    Publishing country England
    Document type Journal Article ; Multicenter Study
    ZDB-ID 1224627-x
    ISSN 1535-2900 ; 1079-2082
    ISSN (online) 1535-2900
    ISSN 1079-2082
    DOI 10.1093/ajhp/zxab482
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  2. Article: Depression in Heart Failure: A Systematic Review.

    Ishak, Waguih William / Edwards, Gabriel / Herrera, Nathalie / Lin, Tiffany / Hren, Kathryn / Peterson, Michael / Ngor, Ashley / Liu, Angela / Kimchi, Asher / Spiegel, Brennan / Hedrick, Rebecca / Chernoff, Robert / Diniz, Marcio / Mirocha, James / Manoukian, Vicki / Ong, Michael / Harold, John / Danovitch, Itai / Hamilton, Michele

    Innovations in clinical neuroscience

    2020  Volume 17, Issue 4-6, Page(s) 27–38

    Abstract: ... ...

    Abstract Objective
    Language English
    Publishing date 2020-06-10
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2675366-2
    ISSN 2158-8341 ; 2158-8333
    ISSN (online) 2158-8341
    ISSN 2158-8333
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  3. Article ; Online: Personalized treatments for depressive symptoms in patients with advanced heart failure: A pragmatic randomized controlled trial.

    IsHak, Waguih William / Korouri, Samuel / Darwish, Tarneem / Vanle, Brigitte / Dang, Jonathan / Edwards, Gabriel / Black, Jeanne T / Aronow, Harriet / Kimchi, Asher / Spiegel, Brennan / Hedrick, Rebecca / Chernoff, Robert / Diniz, Marcio A / Mirocha, James / Manoukian, Vicki / Harold, John / Ong, Michael K / Wells, Kenneth / Hamilton, Michele /
    Danovitch, Itai

    PloS one

    2021  Volume 16, Issue 1, Page(s) e0244453

    Abstract: Objectives: Heart Failure is a chronic syndrome affecting over 5.7 million in the US and 26 million adults worldwide with nearly 50% experiencing depressive symptoms. The objective of the study is to compare the effects of two evidence-based treatment ... ...

    Abstract Objectives: Heart Failure is a chronic syndrome affecting over 5.7 million in the US and 26 million adults worldwide with nearly 50% experiencing depressive symptoms. The objective of the study is to compare the effects of two evidence-based treatment options for adult patients with depression and advanced heart failure, on depressive symptom severity, physical and mental health related quality of life (HRQoL), heart-failure specific quality of life, caregiver burden, morbidity, and mortality at 3, 6 and 12-months.
    Methods: Trial design. Pragmatic, randomized, comparative effectiveness trial. Interventions. The treatment interventions are: (1) Behavioral Activation (BA), a patient-centered psychotherapy which emphasizes engagement in enjoyable and valued personalized activities as selected by the patient; or (2) Antidepressant Medication Management administered using the collaborative care model (MEDS). Participants. Adults aged 18 and over with advanced heart failure (defined as New York Heart Association (NYHA) Class II, III, and IV) and depression (defined as a score of 10 or above on the PHQ-9 and confirmed by the MINI International Neuropsychiatric Interview for the DSM-5) selected from all patients at Cedars-Sinai Medical Center who are admitted with heart failure and all patients presenting to the outpatient programs of the Smidt Heart Institute at Cedars-Sinai Medical Center. We plan to randomize 416 patients to BA or MEDS, with an estimated 28% loss to follow-up/inability to collect follow-up data. Thus, we plan to include 150 in each group for a total of 300 participants from which data after randomization will be collected and analyzed.
    Conclusions: The current trial is the first to compare the impact of BA and MEDS on depressive symptoms, quality of life, caregiver burden, morbidity, and mortality in patients with depression and advanced heart failure. The trial will provide novel results that will be disseminated and implemented into a wide range of current practice settings.
    Registration: ClinicalTrials.Gov Identifier: NCT03688100.
    MeSH term(s) Aged ; Antidepressive Agents/therapeutic use ; Depression/complications ; Depression/drug therapy ; Depression/psychology ; Depression/therapy ; Disease Progression ; Evidence-Based Medicine ; Female ; Heart Failure/complications ; Heart Failure/psychology ; Humans ; Male ; Middle Aged ; Precision Medicine ; Psychotherapy ; Quality of Life
    Chemical Substances Antidepressive Agents
    Language English
    Publishing date 2021-01-07
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0244453
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  4. Article ; Online: Transplantation of human neural progenitor cells secreting GDNF into the spinal cord of patients with ALS: a phase 1/2a trial.

    Baloh, Robert H / Johnson, J Patrick / Avalos, Pablo / Allred, Peggy / Svendsen, Soshana / Gowing, Genevieve / Roxas, Kristina / Wu, Amanda / Donahue, Becky / Osborne, Sheryl / Lawless, George / Shelley, Brandon / Wheeler, Koral / Prina, Carolyn / Fine, Dana / Kendra-Romito, Tami / Stokes, Haniah / Manoukian, Vicki / Muthukumaran, Abirami /
    Garcia, Leslie / Bañuelos, Maria G / Godoy, Marlesa / Bresee, Catherine / Yu, Hong / Drazin, Doniel / Ross, Lindsey / Naruse, Robert / Babu, Harish / Macklin, Eric A / Vo, Ashley / Elsayegh, Ashraf / Tourtellotte, Warren / Maya, Marcel / Burford, Matthew / Diaz, Frank / Patil, Chirag G / Lewis, Richard A / Svendsen, Clive N

    Nature medicine

    2022  Volume 28, Issue 9, Page(s) 1813–1822

    Abstract: Amyotrophic lateral sclerosis (ALS) involves progressive motor neuron loss, leading to paralysis and death typically within 3-5 years of diagnosis. Dysfunctional astrocytes may contribute to disease and glial cell line-derived neurotrophic factor (GDNF) ... ...

    Abstract Amyotrophic lateral sclerosis (ALS) involves progressive motor neuron loss, leading to paralysis and death typically within 3-5 years of diagnosis. Dysfunctional astrocytes may contribute to disease and glial cell line-derived neurotrophic factor (GDNF) can be protective. Here we show that human neural progenitor cells transduced with GDNF (CNS10-NPC-GDNF) differentiated to astrocytes protected spinal motor neurons and were safe in animal models. CNS10-NPC-GDNF were transplanted unilaterally into the lumbar spinal cord of 18 ALS participants in a phase 1/2a study (NCT02943850). The primary endpoint of safety at 1 year was met, with no negative effect of the transplant on motor function in the treated leg compared with the untreated leg. Tissue analysis of 13 participants who died of disease progression showed graft survival and GDNF production. Benign neuromas near delivery sites were common incidental findings at post-mortem. This study shows that one administration of engineered neural progenitors can provide new support cells and GDNF delivery to the ALS patient spinal cord for up to 42 months post-transplantation.
    MeSH term(s) Amyotrophic Lateral Sclerosis/therapy ; Animals ; Disease Models, Animal ; Glial Cell Line-Derived Neurotrophic Factor/genetics ; Humans ; Neural Stem Cells ; Spinal Cord ; Superoxide Dismutase
    Chemical Substances Glial Cell Line-Derived Neurotrophic Factor ; Superoxide Dismutase (EC 1.15.1.1)
    Language English
    Publishing date 2022-09-05
    Publishing country United States
    Document type Clinical Trial, Phase I ; Clinical Trial, Phase II ; Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 1220066-9
    ISSN 1546-170X ; 1078-8956
    ISSN (online) 1546-170X
    ISSN 1078-8956
    DOI 10.1038/s41591-022-01956-3
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  5. Article ; Online: COVID-19 Impact on Acute Ischemic Stroke Treatment at 9 Comprehensive Stroke Centers across Los Angeles.

    Padrick, M Maximillian / Sangha, Navdeep / Paletz, Laurie / Mirocha, James / Figueroa, Sonia / Manoukian, Vicki / Schlick, Konrad / Lyden, Patrick D / Liebeskind, David S / Chatfield, Fiona K / Tarpley, Jason W / Burgos, Adrian / Tenser, Matthew / Gaffney, Denise / Pech, Marco A / Nazareth, Edward / Jackson, Robert / Kauffman, Helaine / Arnold, Lisa /
    Cox, Jennifer / Joyce, Treasure / Nakamura, Catrice / Fitzgerald, Darcie / Ogami, Kyle / Steiner, Nili / Wolber, Nicole / Robertson, Betty / Izzo, Rachel / Gorski, Stefanie / Manuel, Heather / Valdez, Krystal / Reyes, Liliana / Sharma, Latisha K / Song, Shlee S

    Cerebrovascular diseases (Basel, Switzerland)

    2021  Volume 50, Issue 6, Page(s) 707–714

    Abstract: Objective: To describe the impact of COVID-19 on acute cerebrovascular disease care across 9 comprehensive stroke centers throughout Los Angeles County (LAC).: Methods: Volume of emergency stroke code activations, patient characteristics, stroke ... ...

    Abstract Objective: To describe the impact of COVID-19 on acute cerebrovascular disease care across 9 comprehensive stroke centers throughout Los Angeles County (LAC).
    Methods: Volume of emergency stroke code activations, patient characteristics, stroke severity, reperfusion rates, treatment times, and outcomes from February 1 to April 30, 2020, were compared against the same time period in 2019. Demographic data were provided by each participating institution.
    Results: There was a 17.3% decrease in stroke code activations across LAC in 2020 compared to 2019 (1,786 vs. 2,159, respectively, χ2 goodness of fit test p < 0.0001) across 9 participating comprehensive stroke centers. Patients who did not receive any reperfusion therapy decreased by 16.6% in 2020 (1,527) compared to 2019 (1,832). Patients who received only intravenous thrombolytic (IVT) therapy decreased by 31.8% (107 vs. 157). Patients who received only mechanical thrombectomy (MT) increased by 3% (102 vs. 99). Patients who received both IVT and MT decreased by 31.8% (45 vs. 66). Recanalization treatment times in 2020 were comparable to 2019. CSCs serving a higher proportion of Latinx populations in the eastern parts of LAC experienced a higher incidence of MT in 2020 compared to 2019. Mild increase in stroke severity was seen in 2020 compared to 2019 (8.95 vs. 8.23, p = 0.046). A higher percentage of patients were discharged home in 2020 compared to 2019 (59.5 vs. 56.1%, p = 0.034), a lower percentage of patients were discharged to skilled nursing facility (16.1 vs. 20.7%, p = 0.0004), and a higher percentage of patients expired (8.6 vs. 6.3%, p = 0.008).
    Conclusion: LAC saw a decrease in overall stroke code activations in 2020 compared to 2019. Reperfusion treatment times remained comparable to prepandemic metrics. There has been an increase in severe stroke incidence and higher volume of thrombectomy treatments in Latinx communities within LAC during the pandemic of 2020. More patients were discharged home, less patients discharged to skilled nursing facilities, and more patients expired in 2020, compared to the same time frame in 2019.
    MeSH term(s) Brain Ischemia/diagnosis ; Brain Ischemia/epidemiology ; Brain Ischemia/therapy ; COVID-19 ; Fibrinolytic Agents/adverse effects ; Humans ; Ischemic Stroke ; Los Angeles/epidemiology ; Retrospective Studies ; SARS-CoV-2 ; Stroke/diagnosis ; Stroke/epidemiology ; Stroke/therapy ; Thrombectomy ; Thrombolytic Therapy ; Time-to-Treatment ; Treatment Outcome
    Chemical Substances Fibrinolytic Agents
    Language English
    Publishing date 2021-06-25
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 1069462-6
    ISSN 1421-9786 ; 1015-9770
    ISSN (online) 1421-9786
    ISSN 1015-9770
    DOI 10.1159/000516908
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  6. Article ; Online: Protein binding in patients with late-life depression.

    Kumar, Anand / Kepe, Vladimir / Barrio, Jorge R / Siddarth, Prabha / Manoukian, Vicki / Elderkin-Thompson, Virginia / Small, Gary W

    Archives of general psychiatry

    2011  Volume 68, Issue 11, Page(s) 1143–1150

    Abstract: Context: Depression has been identified as a risk factor and a prodrome of dementia. Common neurobiological mechanisms may underlie this clinical and phenomenologic overlap.: Objective: To examine and compare protein (amyloid and tau) binding in ... ...

    Abstract Context: Depression has been identified as a risk factor and a prodrome of dementia. Common neurobiological mechanisms may underlie this clinical and phenomenologic overlap.
    Objective: To examine and compare protein (amyloid and tau) binding in critical brain regions in patients diagnosed as having late-life major depressive disorder (MDD) and healthy control individuals using 2-(1-{6-[(2-[(18)F]fluoroethyl)(methyl)-amino]-2-naphthyl}ethylidene) malononitrile ([(18)F]FDDNP) positron emission tomography.
    Design: A cross-section neuroimaging study using positron emission tomography.
    Setting: University of California, Los Angeles. Patients  Our samples comprised 20 patients diagnosed as having MDD and 19 healthy control individuals of comparable age, sex, and educational level. Main Outcome Measure  Relative distribution volume in regions of interest was used as the measure of [(18)F]FDDNP binding in all study participants.
    Results: When compared with controls, [(18)F]FDDNP binding was significantly higher overall and in the posterior cingulate and lateral temporal regions in the MDD group.
    Conclusions: These findings suggest that neuronal injury associated with higher protein load in critical brain regions might provide a mechanism in the pathophysiologic manifestation of MDD in late life and have implications for the therapeutics of depression in elderly individuals.
    MeSH term(s) Age of Onset ; Aged ; Amyloid beta-Peptides/metabolism ; Cross-Sectional Studies ; Dementia/etiology ; Dementia/metabolism ; Dementia/pathology ; Depressive Disorder, Major/complications ; Depressive Disorder, Major/epidemiology ; Depressive Disorder, Major/metabolism ; Depressive Disorder, Major/pathology ; Female ; Gyrus Cinguli/metabolism ; Gyrus Cinguli/pathology ; Humans ; Male ; Middle Aged ; Neuroimaging/methods ; Plaque, Amyloid/metabolism ; Positron-Emission Tomography ; Protein Binding ; Temporal Lobe/metabolism ; Temporal Lobe/pathology ; tau Proteins/metabolism
    Chemical Substances Amyloid beta-Peptides ; tau Proteins
    Language English
    Publishing date 2011-11-07
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 211589-x
    ISSN 1538-3636 ; 0003-990X
    ISSN (online) 1538-3636
    ISSN 0003-990X
    DOI 10.1001/archgenpsychiatry.2011.122
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