Efforts to increase the use of emergency

The powerful medication can save lives and stave Gucci outlet, gucci bags, cheap gucci shoes 2012 sale off lasting disability after a stroke, but experts believe it needs to be given within 4.5 hours of the start of symptoms. Almost 25 percent of people who have strokes have them while they are asleep, the study authors noted, and doctors typically err on the side of caution, assume the stroke happened when the patient first went to bed and do not treat with tPA. However, in this latest study, doctors from King's College Hospital in London used a stroke registry to compare 326 patients treated with tPA within 4.5 hours of symptoms to 68 "wake-up" stroke patients. The second group only received clot-busting drugs if they had similar symptoms and showed the same signs of early stroke-related brain changes on CT scans that people whose strokes occurred within the 4.5-hour window did. The risks, namely bleeding, of giving tPA outside of this window are thought to outweigh its benefits. In the study, the death rates, risk of bleeding inside the brain and recovery rates after three months were similar in both groups of stroke patients. "Our study shows that administering clot-busting drugs to patients with wake-up stroke who have the same clinical and imaging features as those treated within current guidelines is feasible and safe," study author Dr. Dulka Manawadu, a medical consultant at King's College Hospital, said in a news release, although he added that more research is needed to confirm the findings. The study was slated to be presented Wednesday at the American Stroke Association meeting in New Orleans. Research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed medical journal. Of the similar findings between groups,"it is encouraging and it doesn't yet prove that they will get the same benefits, but it doesn't seem that the risk is excessive," said Dr. Steven Greenberg, vice chairman of gucci outlet the International Stroke Conference 2012's program committee and a professor of neurology at Harvard Medical School. "Even if only a subset of wake-up stroke patients were eligible for tPA, it is still a subset of a substantially large number, so the importance is pretty high." The bottom line remains unchanged, he said: "If you or someone you know is having a stroke, call 911 or get to an emergency room as fast as possible. The earlier treatment is started within the 4.5-hour window, the better. With every minute that goes by, you lose part of the benefit and gain more risk." "A large number of patients can't receive tPA is because they are too far past the window of opportunity," added Dr. M. Shazam Hussain, a neurologist at the Cleveland Clinic, in Ohio. Most "wake-up" strokes do occur close to when a person wakes up, he noted, so "potentially this will expand treatment quite significantly." University of California, San Diego, researchers looked at 192 Hispanic and 925 non-Hispanics who suffered an ischemic stroke (reduced blood flow to the brain) and were treated at five hospitals in San Diego. They found that only 29 percent of Hispanic patients had favorable outcomes after 90 days, compared with 40 percent of non-Hispanic whites. Hispanic patients were less likely to be brought to a hospital by ambulance, with only 73 percent of Hispanics using emergency medical services, compared to 83 percent of non-Hispanic whites. Hispanic stroke patients were younger and more likely to be female and to have diabetes. There were no differences between Hispanic and non-Hispanic patients in terms of time between stroke onset and arrival at hospital or treatment decision. After they adjusted for stroke complications, the researchers concluded that the odds of favorable outcomes for Hispanic patients was about half that of non-Hispanic patients. Efforts to increase the use of emergency medical services by Hispanics may decrease the disparity in stroke outcomes, the researcher said. The study was to be presented Wednesday at the American Stroke gucci bags Association meeting in New Orleans.