So still a COMPLETE FAILURE AT 100% RECOVERY: THE ONLY GOAL IN STROKE FOR SURVIVORS!
You're so fucking incompetent, you're not even measuring for that!
Here is your business101 requirements.
Oops, I'm not playing by the polite rules of Dale Carnegie, 'How to Win Friends and Influence People'.
Telling stroke medical persons they know nothing about stroke is a no-no even if it is true.
Politeness will never solve anything in stroke. Yes, I'm a bomb thrower and proud of it. Someday a stroke 'leader' will try to ream me out for making them look bad by being truthful, I look forward to that day.
Send me personal hate mail on this: oc1dean@gmail.com. I'll print your complete statement with your name(If you can't stand by your name don't bother replying anonymously) and my response in my blog. Or are you afraid to engage with my stroke-addled mind? No excuses are allowed! You're medically trained; it should be simple to precisely state EXACTLY WHY you aren't working on 100% recovery protocols with NO EXCUSES!
Tenecteplase for Acute Ischemic Stroke at 4.5 to 24 Hours: A Meta-Analysis of Randomized Controlled Trials
Zixin Wang, MM, Jiamin Li, MM, Xinyi Wang, MBBS, Boyi Yuan, MM, Jiameng Li, MBBS, and Qingfeng Ma, MD https://orcid.org/0000-0002-0114-6402 m.qingfeng@163.comAuthor Info & Affiliations
Stroke
New online
https://doi.org/10.1161/STROKEAHA.125.053256
Abstract
BACKGROUND:
Whether TNK (tenecteplase) benefits patients with acute ischemic stroke treated within 4.5 to 24 hours remains uncertain, and no previous meta-analysis has differentiated between clinical settings where endovascular thrombectomy (EVT) is unavailable or permitted, leading to pooled distinct clinical contexts and obscuring a clear estimation of TNK’s net effect.
METHODS:
We searched for randomized controlled trials comparing intravenous TNK of 0.25 mg/kg with standard care or placebo in adults within 4.5 to 24 hours after acute ischemic stroke onset. The primary outcome was excellent functional outcome (modified Rankin Scale score, 0–1) at 90 days, with additional efficacy and safety end points. A random-effects meta-analysis was performed both overall and within predefined subgroups, stratified by whether EVT was permitted in individual studies (non-EVT versus EVT-permitted).
RESULTS:
Four multicenter randomized controlled trials enrolling 1278 patients were included. TNK significantly increased excellent functional outcome (odds ratio [OR], 1.34 [95% CI, 1.06–1.71]; P=0.02) at 90 days and recanalization (OR, 3.30 [95% CI, 1.59–6.84]; P=0.001) compared with the control group, whereas good functional outcome (modified Rankin Scale score, 0–2), reperfusion, and early neurological improvement did not differ significantly. Subgroup analyses of 596 patients in the non-EVT subgroup showed that TNK significantly improved excellent functional outcome (OR, 1.46 [95% CI, 1.02–2.08]; P=0.04), good functional outcome (OR, 1.50 [95% CI, 1.07–2.09]; P=0.02), recanalization (OR, 6.17 [95% CI, 3.36–11.33]; P<0.00001), and early neurological improvement (OR, 3.21 [95% CI, 1.82–5.66]; P<0.0001). However, in the EVT-permitted subgroup of 682 patients, TNK only improved recanalization (OR, 2.36 [95% CI, 1.34–4.17]; P=0.003). No significant differences were observed between TNK and control in the risks of symptomatic intracerebral hemorrhage or 90-day mortality, either in the overall or subgroup analyses.
CONCLUSIONS:
TNK improves(NOT GOOD ENOUGH! 100% RECOVERY IS THE ONLY GOAL! Quit using your tyranny of low expectations to justify complete fucking failure at your job!) excellent functional outcomes and recanalization in patients with acute ischemic stroke treated within 4.5 to 24 hours, without increasing the risks of symptomatic intracerebral hemorrhage or mortality. Notably, extended-window TNK provides greater additional benefits when EVT is inaccessible, establishing its role as an alternative reperfusion strategy in resource-limited settings.
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