University of Texas Specialized Program in Acute Stroke

描述：（申请人提供摘要）： 过去20年的中风研究表明，急性中风是一种可治疗的疾病， 损伤的可逆性与时间密切相关。在实验室中可以找到令人兴奋的治疗策略，但很难设计和开展临床研究，将其转化为临床效益。即使证明了有效的治疗方法，要使其被采用和广泛使用，也存在着意想不到的巨大障碍。鉴于中风在我们老龄化人口中的巨大公共卫生问题，这些难题需要我们的关注。它们是UT卒中项目和SPOTRIAS PA的重点。我们卒中项目的主题模式是通过以下方式改进急性卒中的治疗：1）卒中生物学的实验室研究，2）基于这些实验室研究的新疗法的临床研究，3）有效疗法的结局评估和改进应用。该计划有三个主要的具体目标：1。通过基于实验室学习的缺血性损伤生物学原理的临床研究项目，开发有效的新型急性卒中治疗方法。我们将描述四项计划中的新型急性干预措施的1期或2期临床试验;咖啡因醇用于神经保护，凝血酶抑制剂阿加曲班用于增强TPA后的再灌注，超声用于增强TPA后的凝块溶解，以及限制诱导运动疗法以扩大恢复。这些项目需要EMS、急诊医学、放射学、重症监护、超声和康复等多学科的参与。 2.通过改善急性脑卒中的治疗方法， 利用尖端的远程医疗技术组织地方和区域中风中心， 和评估一个新的中学教育倡议，以帮助解决的问题， 公众知识不足。 3.开发临床、统计、人体组织和培训“核心”，以促进实现具体目标1和2。这些核心还将为研究金培训提供重要的新资源。

DESCRIPTION: (abstract provided by the applicant): The past 20 years of stroke research have shown that acute stroke is a treatable disease but reversibility of damage is tightly time dependent. It is possible to find exciting treatment strategies in the laboratory, but difficult to design and carry out clinical research to translate them into clinical benefit. Even when effective therapy is demonstrated, there are unexpectedly huge impediments to having it adopted and widely available. Given the massive public health problem of stroke in our aging population, these conundrums demand our attention. They are the foci of the UT Stroke Program and the SPOTRIAS PA. The thematic model of our Stroke Program is to develop improved treatment of acute stroke by 1) laboratory investigation into the biology of stroke, 2) clinical investigation of new therapies based on these laboratory studies, and 3) assessment of outcome and improved application of effective therapies. This Program Project has three broad Specific Aims: 1. Development of effective new acute stroke therapies through clinical research projects based on biological principles of ischemic injury learned in the laboratory. We will describe four planned Phase 1 or 2 Clinical trials of novel acute interventions; caffeinol for neuroprotection, the thrombin inhibitor argatroban to enhance reperfusion after TPA, ultrasound to augment clot lysis after TPA, and constraint induced movement therapy to amplify recovery. These projects require the multidisciplinary involvement of EMS, Emergency Medicine, Radiology, Critical Care, Ultrasound, and Rehabilitation. 2. Application of more efficient and widespread acute stroke treatment by improving the organization of local and regional stroke centers using cutting-edge telemedicine technology, and evaluation of a novel middle-school educational initiative to help solve the problem of inadequate public knowledge. 3. Development of Clinical, Statistical, Human Tissue, and Training "Cores" that will facilitate the accomplishment of Specific Aims # 1 and 2. These cores will also provide important new resources for fellowship training.