Posted on 01/17/2006 3:06:05 PM PST by neverdem
The Doctor's World
The life-threatening stroke that Israeli Prime Minister Ariel Sharon suffered early this month has focused attention on the treatment of strokes, in particular the use of anticoagulants and clot-dissolving drugs.
The use of such drugs is among the most potentially dangerous therapies in medicine and one of the most controversial. The full story of Mr. Sharon's case is not known because his family and doctors have released limited information. But questions have been raised about whether the drugs he received for a less severe stroke in December, caused by a blood clot, may have contributed to his huge stroke on Jan. 4.
The use of anticoagulants and clot dissolvers is controversial, in part because their benefits must be weighed against their risks. Drugs like tissue plasminogen activator, or T.P.A., for example, can be lifesaving if given within a few hours after the onset of an ischemic stroke but lethal if started only a few hours later. Though many people call T.P.A. an anticoagulant, it is a different type of drug that dissolves clots.
T.P.A. can allow patients to survive the first few days after a stroke begins - a period during which many patients would almost surely die without such therapy. But the trade-off is that many of them are left paralyzed, unable to speak and suffering from severe intellectual impairments.
Heparin, a short-acting anticoagulant, is given to prevent a recurrent stroke, not to dissolve the offending clot. But giving it can be dicey in the early stages of a stroke because it can help turn a mild ischemic stroke into a devastating bleeding one.
"It is hard to imagine that a single treatment can shift so radically from making you better and saving your life, to one that could kill you," said Dr. Lee H. Schwamm...
(Excerpt) Read more at nytimes.com ...
Administering Stem Cells To Patients With Myocardial Infarction Leads To Reduction Of The Infarct
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Ahh, the Slimes is always such an uplifting read.
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