Saturdays News - tPA (Tissue Plasminogen Activator)

Definition: Tissue Plasminogen Activator from Wikipedia, the Free Encyclopedia.

Tissue plasminogen activator (abbreviated tPA or PLAT) is a protein involved in the breakdown of blood clots. It is a serine protease (EC 3.4.21.68) found on endothelial cells, the cells that line the blood vessels. As an enzyme, it catalyzes the conversion of plasminogen to plasmin, the major enzyme responsible for clot breakdown. Because it works on the clotting system, tPA is used in clinical medicine to treat embolic or thrombotic stroke. Use is contraindicated in hemorrhagic stroke and head trauma.

tPA may be manufactured using recombinant biotechnology techniques. tPA created this way may be referred to as recombinant tissue plasminogen activator (rtPA).

A simplified illustration demonstrates clot breakdown (fibrinolysis),
with blue arrows denoting stimulation, and red arrows inhibition

Clinical Applications

tPA is used in diseases that feature blood clots, such as pulmonary embolism, myocardial infarction, and stroke, in a medical treatment called thrombolysis. To be most effective in ischemic stroke, tPA must be administered as early as possible after the onset of symptoms. Protocol guidelines require its use intravenously within the first three hours of the event, after which its detriments may outweigh its benefits. They can either be administered systemically, in the case of acute myocardial infarction, acute ischemic stroke, and most cases of acute massive pulmonary embolism, or administered through an arterial catheter directly to the site of occlusion in the case of peripheral arterial thrombi and thrombi in the proximal deep veins of the leg.

The guideline in Ontario, Canada hospitals for ischemic strokes is that tPA must be given within 4.5 hours of the onset of symptoms. Because of this, only about 3% of patients qualify for this treatment, since most patients do not seek medical assistance quickly enough.

In the United States, the window of administration used to be 3 hours from onset of symptoms, but the newer guidelines also recommend use up to 4.5 hours after symptom onset. tPA appears to show benefit not only for large artery occlusions but also for lacunar strokes.

Since tPA dissolves blood clots, there is risk of hemorrhage with its use. tPA has also been given to patients with acute ischemic stroke above age 90 years old. Although a small fraction of patients 90 years and above treated with tPA for acute ischemic stroke recover, most patients have a poor 30-day functional outcome or die. Nonagenarians may do as well as octogenarians following treatment with IV-tPA for acute ischemic stroke. In addition, people with frostbite treated with tPA had fewer amputations than those not treated with tPA. In tPA overdose, aminocaproic acid works as an antidote.

See the full article Tissue Plasminogen Activator from Wikipedia, the Free Encyclopedia.

Katie Jerdee - Stroke Lobby Day (tPA)

Survivor Katie Jerdee tells her story about having a stroke while running during soccer practice and the importance of knowing the stroke warning signs.

Stroke Specialists Regarding tPA (in Australia)

Saturdays Comics - Nov/10/2012

For Better and For Worse Lynn Johnston / 2007-05-17 "But ... I need someone to talk to!"	Dilbert Scott Adams / 2012-11-09 "Let me tell you what kind of day I had at work"
Garfield Jim Davis / 2012-11-06 "Bad mood coming through !"	Betty Delainey & Rasmussen / 2012-11-05 "This is nuts! I know let's do the self-checkout."

* For Better and For Worse" is a serious topic of stroke but with a very nice cartoons. It is all about Grandpa Jim had a stroke and 88 further cartoon "strips" that happened to Grandpa Jim. (See as well  the author Lynn Johnston).

** I tried to get low or free price at the people http://www.UniversalUclick.com/ for the images for the cartoons. It was too high for Stroke Survivors Tattler i.e. we are not a regular newspaper and our budget is very low. Fortunately, you will have to do only 1-click more to see the cartoon image, it is legit and it is free using GoComics.com and Dilbert.com.

*** Changed from "Pickles" to "Betty" -- "Betty" is a excellent cartoon and Gary Delainey & Gerry Rasmussen are authors/artists/cartoon-strips and they live in Edmonton.

Saturday - Eclectic Stuff & Articles - Nov/10/2012

Definition:Eclectic(noun) a person who derives ideas, style, or taste from a broad and diverse range of sources.

Article: SSTattler - Remembrance Day

John - SSTattler

Remembrance Day From Wikipedia, the free encyclopedia.

Remembrance Day (also known as Poppy Day or Armistice Day) is a memorial day observed in Commonwealth countries since the end of World War I to remember the members of their armed forces who have died in the line of duty. This day, or alternative dates, are also recognized as special days for war remembrances in many non-Commonwealth countries. Remembrance Day is observed on 11 November to recall the end of hostilities of World War I on that date in 1918. Hostilities formally ended "at the 11th hour of the 11th day of the 11th month," in accordance with the Armistice, signed by representatives of Germany and the Entente between 5:12 and 5:20 that morning. ("At the 11th hour" refers to the passing of the 11th hour, or 11:00 a.m.) World War I officially ended with the signing of the Treaty of Versailles on June 28, 1919.

The day was specifically dedicated by King George V on 7 November 1919 as a day of remembrance for members of the armed forces who were killed during World War I. This was possibly done upon the suggestion of Edward George Honey to Wellesley Tudor Pole, who established two ceremonial periods of remembrance based on events in 1917.

The red remembrance poppy has become a familiar emblem of Remembrance Day due to the poem "In Flanders Fields". These poppies bloomed across some of the worst battlefields of Flanders in World War I, their brilliant red colour an appropriate symbol for the blood spilled in the war.

In Canada

In Canada, Remembrance Day is a public holiday and federal statutory holiday, as well as a statutory holiday in all three territories and in eight of the ten provinces (Ontario and Quebec being the exceptions). From 1921 to 1930, the Armistice Day Act provided that Thanksgiving would be observed on Armistice Day, which was fixed by statute on the Monday of the week in which November 11 fell. In 1931, the federal parliament adopted an act to amend the Armistice Day Act, providing that the day should be observed on November 11 and that the day should be known as "Remembrance Day".

Remembrance Day in Canada. The memorial at the McCrae House;
two Canadian-style poppy pins can be seen resting on the sculpture.

The federal department of Veterans Affairs Canada states that the date is of "remembrance for the men and women who have served, and continue to serve our country during times of war, conflict and peace"; specifically, the First and Second World Wars, the Korean War, and all conflicts since then in which members of the Canadian Forces have participated. The department runs a program called Canada Remembers with the mission of helping young and new Canadians, most of whom have never known war, "come to understand and appreciate what those who have served Canada in times of war, armed conflict and peace stand for and what they have sacrificed for their country".

In United States

Veterans Day is observed in the United States on 11 November, and is both a federal holiday and a state holiday in all states. However, the function of the observance elsewhere is more closely matched by Memorial Day in May. In the United States, and some other allied nations, 11 November was formerly known as Armistice Day; in the United States it was given its new name in 1954 at the end of the Korean War to honor all veterans. Veterans Day is observed with memorial ceremonies, salutes at military cemeteries, and parades.

See the full article Remembrance Day From Wikipedia, the free encyclopedia.

Article: Dean - Clotbusters Print E-mail UAB Explores Innovative Stroke Therapies

Dean's Stroke Musing

I wonder if this trial started in 2011 and the results: Clotbusters at UAB. -- Dean's Stroke Musing.

In 1947, as tension between Russia and the United States threatened to erupt into nuclear war, the Bulletin of the Atomic Scientists added a new element to its cover: a stylized clock face with the hands set at seven minutes to midnight. For the past 63 years, the clock’s minute hand has moved back and forth to reflect the imminence of nuclear holocaust.

In the world of stroke care, the countdown to doomsday begins as soon as the brain’s oxygen supply is disrupted, either through a blood clot (ischemic stroke—the cause of 80 percent of strokes) or by bursting blood vessels (hemorrhagic stroke, which accounts for the other 20 percent of cases). Stroke kills more people worldwide than any other disease. It is the third leading cause of death in the United States and the leading cause of serious, long-term disability.

Left to right: Damon Patterson,
Andrei Alexandrov, and Anne
Alexandrov. Andrei Alexandrov is
leading a team of researchers and
clinicians testing innovative new
stroke therapies.

For years, the stroke clock was set at three hours. Patients receiving emergency treatment before that time stood a good chance of recovering significant function; after the three-hour window closed, there wasn’t much hope. But new advances in stroke treatment are steadily pushing open the treatment window and adding precious time back onto the clock. Neurologist Andrei Alexandrov, M.D., and his team at the UAB Comprehensive Stroke Research Center are contributing many of those breakthroughs, developing and testing revolutionary therapies that are effective several hours, days, and even weeks after stroke onset .....

See the full article Clotbusters Print E-mail UAB Explores Innovative Stroke Therapies at Deans' Stroke Musings.

Many other good articles as well in tPA at Deans' Stroke Musings.

Eclectic: Monty - Unbelievable Hero Mom.

Monty - SSTattler

During an early morning response to a house fire in Santa Rose de Temuco, Chile,  firefighters witnessed the unbelievable. A mother dog risked her life to save her puppies from the fire surrounding the burning house, which started because of a car bomb ...

Article: Ralph - Remembrance Day - Soldier Cry

Ralph - SSTattler

Remembrance Day - Soldier Cry

This is a tribute done by Global Edmonton for Remembrance Day. I have prommise to broadcast as long as they are credited.

We are too far removed from the lessons of the past. Most of us have no idea of what true hardship and bloodshed are like. Most have no idea what Pillars our soldiers are and how they are the thin Wall between us and re-learning those lessons. Blood, sweat, tears and the Hardship of the few are the Shield for the many. The shield that most never even notice. I hope that there will never be a time again when they will be forced to notice that Shield, and Fear its failure... God Bless the Few!  -- Jeff's Favs

Article: Jackie - Remembrance Day (Poem)

Jackie - SSTattler

                                           Remembrance Day

                                                 He was getting old and paunchy

                                                    And his hair was falling fast,

                                                   And he sat around the Legion,

                                                       Telling stories of the past.

                                                  Of a war that he once fought in

                                                  And the deeds that he had done,

                                                  In his exploits with his buddies;

                                                   They were heroes, every one.

And tho' sometimes to his neighbours

His tales became a joke,

All his buddies listened quietly

For they knew whereof he spoke.

But we'll hear his tales no longer,

For old Bob has passed away,

And the world's a little poorer

For a Soldier died today.

Eclectic: Diane - Happy Monday!

Diane - The Pink House OTC

This morning, I woke up to the sound of rain on the window. The first thing I thought was, well, I can roll over and catch a little more sleep because I won't be taking the dog on a long walk in this  weather.

The second thing I thought was, oh yeah, the blood draw guy is coming at 8:30 a.m., so I better get going.

The third thing I thought: today is my birthday.

And I wondered if Bob would remember.

When we were dating, Bob told me that he was glad my birthday was the day after Halloween, because that made it easy to remember. He said he'd never forget my birthday.

My 4th Birthday.

My mom made the best cakes!

I don't know why it's so important that Bob remember my birthday. Sometimes I wonder why birthdays are important at all. It is, it seems, just a way to mark the passing of time.

But I suppose a birthday becomes important because birthdays are such a big deal when we are kids. A birthday was like Christmas, but better. Something anticipated year long. Getting older, back then, was great.

Getting older is not so great anymore... and still, I look at the calendar and anticipate a celebration of sorts.

Yesterday was Halloween. In the morning, I said to Bob ....

See the full article Happy Monday! in The Pink House On The Corner.

Eclectic: SSTattler - Buddy, the Buddy Holly Story

John - SSTattler

Buddy, the Buddy Holly Story

TUESDAY, NOV 13, 2012 – SUNDAY, FEB 3, 2013

Location:       Mayfield Dinner Theatre 
                16615 - 109 Avenue
City / Town:    Edmonton
Description:    Dinner Theatre
Event Category: Theatre
Where to purchase tickets: purchase.tickets.com …
Tickets Phone:  780.483.4051
Link:           www.mayfieldtheatre.ca

Buddy Holly in 1957

OH BOY…Buddy is back, by overwhelming demand! Experience the incredible legacy of the young man with glasses, whose musical career spanned an all-too-brief period during the golden days of rock ‘n’ roll. On February 3rd, 1959, the man who changed the face of popular music tragically died in a plane crash aged 22.

Now, Buddy: The Buddy Holly Story tells the tale of the three years in which he became the world’s top recording artist with a show that features over 20 of Buddy Holly’s greatest hits including “Peggy Sue”, “That’ll Be The Day”, “Oh Boy”, “Not Fade Away”, “Everyday”, “Rave On”, “Maybe Baby”, “Raining In My Heart”, plus Ritchie Valens’ “La Bamba”, and the Big Bopper’s “Chantilly Lace”.

This incredibly popular production is back with added scenes, a new look, and the same energetic music that you loved the first time around!
(SSTattler: It is a little bit expensive (approx $100 per ticket) but you heard "Buddy" then you have to go!)

Buddy Holly

     From Wikipedia, the free encyclopedia.

Article: Sharon - Is tPA And Emergency Treatment The Only Answer?

Is tPA and Emergency Treatment the Only Answer?

Sharon - SSTattler

The newest type of medical malpractice suits are patients and their families who don’t get tPA (Avitzur).  Initially the “door to needle” time was within 3 hours of stroke, but European Cooperative Acute Stroke Study (ECASS-3) showed evidence of an expanded time window of between 3.0 and 4.5 hours for persons experiencing   acute ischemic stroke symptoms. In 2009 Neurologists, McCullough and Dearborn lamented how many people ignored the symptoms of stroke until the window for tPA has passed.

“Mrs Jones is like so many others we see on the stroke service every day. As a 64-year-old African–American female, with a history of hypertension, diabetes and poorly controlled cholesterol, she is a common face of stroke in the USA. She was working in Wal-Mart this January when her coworker noticed that her faced looked a little droopy. She ignored it, as she had no pain, until the right side of her body was so weak that she couldn’t stand up. She arrived at the emergency department more than 6 h after her symptoms started, long after the 3-h window for acute treatment with tissue plasminogen activator (rTPA) therapy had passed. When I met her, she was hemiplegic, aphasic and apraxic. Over the next several weeks she developed an ability to name simple objects and repeat simple phrases, but her right side remained paralyzed. She will probably require full-time nursing support with activities of daily living for the remainder of her life.

One frustrating aspect of stroke neurology is that once the time window for acute intervention has passed, patients can only be monitored and medical management optimized as we wait and hope for recovery. Some patients do recover remarkably well, but others remain significantly disabled or unable to resume their former functional status. This is especially true for women, who are much less likely to return to independent living compared with age-matched men.”

Now neurologists and hospitals are worried that those who arrived at the hospital in time to get tPA and didn’t get it will sue the neurologist and the hospital (Avitzur). Likely, winning such a lawsuit and receiving compensation for stroke impairments could make a significant difference to a stroke survivor’s rehabilitation and home adaptation options.

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