Latest news with #ThanhNguyen
Medscape
26-05-2025
- Health
- Medscape
Tenecteplase Before Thrombectomy Boosts LVO Stroke Outcomes
HELSINKI — In patients with large vessel occlusion stroke treated within 4.5 hours of symptom onset, outcomes were better in those who received the thrombolytic tenecteplase prior to endovascular therapy than in those who underwent endovascular treatment alone. Results from the BRIDGE-TNK trial showed that patients who received tenecteplase had a significantly higher likelihood of achieving functional independence at day 90. Several earlier trials of thrombolysis before endovascular therapy — most using alteplase as the thrombolytic — failed to show significant benefit. Commentators now suggest that the latest findings from the BRIDGE-TNK trial suggested tenecteplase may potentially be a more suitable agent in this clinical scenario. 'Essentially, what our trial showed was that patients who received tenecteplase before endovascular therapy did better than those who did not receive tenecteplase. And it was a highly significant result, supporting the idea that we should give tenecteplase to these patients who are presenting directly to endovascular centers. All patients in this trial were directly presenting to the endovascular center,' said study investigator Thanh Nguyen, MD, director of Interventional Neurology/Neuroradiology at Boston Medical Center, Boston. The BRIDGE-TNK trial results were presented on May 21 at the European Stroke Organization Conference (ESOC) 2025 and simultaneously published online in The New England Journal of Medicine. Better Functional Independence The open-label BRIDGE-TNK trial included 550 patients with acute ischemic stroke due to large-vessel occlusion who presented within 4.5 hours of symptom onset and were eligible for thrombolysis. Patients were randomly assigned to receive either intravenous tenecteplase followed by endovascular thrombectomy or endovascular thrombectomy alone. The primary outcome was functional independence at 90 days, measured on a scale from 0 to 6, with higher scores indicating greater disability. Secondary outcomes included successful reperfusion before and after thrombectomy. Safety outcomes assessed symptomatic intracranial hemorrhage within 48 hours and death within 90 days. At 90 days, functional independence — defined as a score of 0-2 on the modified Rankin Scale — was achieved in 52.9% of patients in the tenecteplase-thrombectomy group compared with 44.1% in the thrombectomy-alone group (unadjusted risk ratio, 1.20; 95% CI, 1.01-1.43; P = .04). The time between tenecteplase administration and the start of endovascular therapy was very short — a median of 16 minutes — yet there was still a significant increase in successful reperfusion before thrombectomy in the tenecteplase group (6.1%) vs thrombectomy-alone group (1.1%). Successful reperfusion after thrombectomy occurred in 91.4% of patients in the tenecteplase group and 94.1% in the thrombectomy-alone group. Symptomatic intracranial hemorrhage within 48 hours occurred in 8.5% of patients in the tenecteplase-thrombectomy group and 6.7% in the thrombectomy-alone group — a nonsignificant difference. Ninety-day mortality was 22.3% in the tenecteplase group vs 19.9% in the thrombectomy-alone group. Peter Kelly, MD, professor of neurology at University College Dublin in Dublin, Ireland, who was not involved in the trial, asked Nguyen how the BRIDGE-TNK results should be interpreted in light of previous, 'perhaps inconclusive,' alteplase trials — and why the signals appear to differ between the two agents. Nguyen said that an individual patient meta-analysis of the alteplase trials suggested a potential benefit of administering the drug before thrombectomy in patients treated very early — within 2.5 hours of symptom onset. However, beyond that time window, the benefit appeared to plateau, with no clear advantage observed. 'I think it depends on what you have available at your hospital. So, if you have alteplase, then you use alteplase. If you have tenecteplase, you use tenecteplase. But if you have the choice between the two, then it would seem reasonable to go with tenecteplase because it's showing superiority over the whole 4.5-hour time window,' Nguyen added. Discussing why tenecteplase may be more effective than alteplase in this setting, Nguyen explained that tenecteplase is more fibrin-specific and has been associated with better recanalization outcomes. She added that its bolus administration makes it faster and more convenient than alteplase, which requires an infusion — an important advantage when time is critical for getting patients to the cath lab. Kelly responded: 'So it might be as simple as that; perhaps it's all down to speed again.' He concluded: 'I think the main take home message is not to withhold thrombolytics in patients with large vessel occlusion stroke on the way to endovascular therapy.' In response, Kelly suggested the difference in outcomes might simply come down to timing. 'I think the main take-home message is not to withhold thrombolytics in patients with large vessel occlusion stroke on the way to endovascular therapy. So, it might be as simple as that; perhaps it's all down to speed again,' he said. A Convincing, Positive Result Commenting on the study for Medscape Medical News , Michael Hill, MD, director of the Stroke Unit for the Calgary Stroke Program, Alberta, Canada, said the results supported the use of thrombolysis before endovascular therapy. 'A meta-analysis of alteplase trials in this situation has suggested a benefit, but this trial with tenecteplase shows a more convincing positive result. This is consistent with previous literature suggesting that tenecteplase may be a more effective thrombolytic agent than alteplase and associated with earlier recanalization.' He suggested that the benefit of thrombolysis before thrombectomy may not just be due to the earlier opening of the vessel. 'The endovascular procedure can cause some distal embolization into the far parts of the circulation, so having a drug on board, which is going to help manage those microcirculatory occlusions should be beneficial. But that's still theoretical at present,' Hill said. 'I think the totality of the alteplase data also suggest that it is beneficial, but tenecteplase could be better, so we should be giving tenecteplase to these patients heading for endovascular therapy,' he added. Hill noted that many regions around the world have already adopted tenecteplase as the thrombolytic of choice for stroke treatment.
Yahoo
14-05-2025
- Yahoo
‘Patients were cancelling': Nashville dentist feels impact of ICE activity
NASHVILLE, Tenn. (WKRN) — Though Immigration and Customs Enforcement activity appears to have died down in South Nashville, recent actions have changed the way that people go about their daily lives — even those in the U.S. legally. On Tuesday, the Department of Homeland Security reported that nearly 200 people were arrested this month during a 'public safety operation' with the Tennessee Highway Patrol. The agency claimed that at least 95 of those arrested had previous criminal convictions and pending charges. However, the DHS only released five identities out of the 196 arrested, so News 2 has not been able to verify the validity of the claim. 'We are human beings': The faces and stories of families impacted by ICE activity in Nashville The executive director for the Tennessee Immigrant and Refugee Rights Coalition said some of those arrested were on their way to work. Since the activity, some immigrants have chosen not to drive. Others aren't going out at all. 'Our office name is 'All Smiles Nashville,'' Dentist and Owner of 'All Smiles Nashville,' Dr. Thanh Nguyen, said. 'It's not 'Legal Nashville.' It's not 'Illegal Nashville.' My concern for all patients is: how I can take care of you?' Nguyen told News 2 that last week's ICE acitvity caused a 33% spike in cancellations. 'Patients were canceling left and right — rightfully so, of course,' Nguyen said. 'We have a patient who is in the middle of treatment. I mean, they are in some temporary crowns. These are things that dental school doesn't really teach you.' Nguyen worries that panic could drive patients to avoid critical care or turn to unlicensed clinics. However, the fear isn't limited to undocumented patients; it's affecting legal immigrants, too. 'They are still scared just because they are a part of the Hispanic community regardless of the situation they are living in and how they have done things legally, they are still scared and have designated to taking Uber, which we all know takes a toll out of our paychecks,' dental assistant at All Smiles Nashville, Cristal, said. Nguyen said that some of his employees, who immigrated legally, have also taken rideshares to work because they fear being profiled. 'They are just so afraid to drive right now that they have to Uber half an hour and so they are getting here extra early and staying late and battling through traffic in surge prices and what-not,' Nguyen explained. 'That is just how much they value working in this environment and being able to take care of our patients.' Nguyen, an immigrant himself, said his team and patients are the heart of the clinic. 'It's a purge': Reactions to Nashville's ICE operations, impact on local businesses 'Our employees are the hardest workers, and they are just here to better the lives not only of themselves, but of our community,' Nguyen said. If this incident affected you or a family member, TIRRC urges you to call its resource line at 615-414-1030 for legal information and resources. The coalition also shared this link to offer a review of constitutional rights when interacting with law enforcement or ICE. To donate to The Belonging Fund, an effort to support Nashville immigrants during moments of crisis, follow this link. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
11-05-2025
- Climate
- Yahoo
Two dozen people rescued for heat issues during record-breaking SoCal heat wave
More than two dozen people were rescued Saturday during a record-breaking heat wave as temperatures climbed to the high 90s in parts of Southern California. In Orange County, at least 15 people were rescued for heat-related issues throughout the day, according to Orange County Fire Authority Capt. Thanh Nguyen. That included a group of 11 people in distress who were rescued from one of the trails in unincorporated Newport Coast, Nguyen said. Two were transported to a local hospital, five were evaluated but declined further help, and four experienced heat exhaustion, he said. In Aliso and Wood Canyons Wilderness Park in the San Joaquin Hills, four hikers were rescued as the temperature spiked to 96 degrees. Three of the hikers were affected by the heat, Nguyen said, including one who was airlifted from the area. "Unless you've trained for heat and this tough terrain, we strongly encourage everyone to wait until it cools down," Nguyen said. Another woman affected by the heat was rescued in Anaheim near the 91 Freeway. Firefighters also rescued a woman from Crystal Cove State Park in Newport Beach, Nguyen said. It was unclear if she had also been affected by the high temperatures. In Riverside County, nine people were rescued in heat-related incidents. Rescues occurred in Temecula, Palm Desert, Jurupa Valley, Moreno Valley, La Quinta and the unincorporated area of Lake Elsinore, according to CalFire/Riverside County Fire Department. A dehydrated hiker was rescued at Big Bear Canyon Loop and Ortega Highway Saturday afternoon as the temperature hit 99 degrees. The hiker was airlifted from the area, according to officials, and transported by ambulance to a local hospital. In Los Angeles, a hiker who suffered from heat exhaustion was airlifted from the Hollywood Hills Saturday morning, according to the Los Angeles Fire Department. Griffith Park rangers notified law enforcement about the hiker — a 55-year-old woman — near the Cahuenga Peak trail between the Hollywood sign and Wisdom Tree. The woman was transported to a local hospital after paramedics assessed her condition as weak, LAFD public service officer Lyndsey Lantz said. The heat wave is expected to dip by Sunday, according to the National Weather Service, and give way to May gray skies early next week. Sign up for Essential California for news, features and recommendations from the L.A. Times and beyond in your inbox six days a week. This story originally appeared in Los Angeles Times.
SBS Australia
28-04-2025
- General
- SBS Australia
'It was hell on earth': Vietnamese Australians relieve the Fall of Saigon, 50 years on
Thanh Nguyen was just three years old when the Vietnam War began. His childhood in Saigon — the former capital of South Vietnam — was marred by fear and uncertainty. By 19, he was thrust into battle. Now, half a century after the Fall of Saigon, Nguyen is 73, but his memories remain as vivid as that historic day in April 1975. While for some, it marked the end of a decades-long war, for Nguyen and millions of South Vietnamese veterans like him, it was far from over. Vietnamese civilians and Americans rush toward a US Marine helicopter on 29 April 1975, during the chaotic evacuation of Saigon, as the city fell to North Vietnamese forces. Source: AP / AP Haunted by a war that never ended When the last helicopter packed with evacuees lifted off the rooftop of the US Embassy in Saigon on 30 April 1975, chaos broke out. It was a powerful symbol of America's final withdrawal as the communist North Vietnamese forces closed in and a moment of desperation for thousands of South Vietnamese civilians and allies, many of whom clung to the hope of evacuation. Nguyen's family were among those who chose to stay behind. "Yes, lots of people tried to escape at the time, but we stayed," he tells SBS News. "[Because] I can ask the contrasting question ... where could we go? Everywhere was the same." Thanh Nguyen as a young man in Bien Hoa, Vietnam, before his enlistment. Source: Supplied / Thanh Nguyen Nguyen was 23 at the time Saigon fell, bringing his four years of service to an end. It left him with mixed feelings. "I wasn't interested in joining the army," he says. But then I thought — if I do go, that is how I can contribute to my country. His family had lived beside the Bien Hoa air base, a major target of the Viet Cong — the communist-led South Vietnamese military front backed by North Vietnam. As a boy, Nguyen would climb onto the rooftop to watch helicopters zip through the sky and bullets trace arcs across the horizon. The sound of explosions, sirens, and crying mothers became part of everyday life. "You could see soldiers with guns, grenades ... even when you stepped outside your front door," he recalls. The smell of war lingered too — burnt flesh, gunpowder, rot. Even in his 70s, Nguyen can still remember them now. The fighting happened day and night. Eventually, he says, he joined the fight out of a sense of duty. 'I always told my soldiers: 'From now on, you and I are one family. My siblings are far away and if I fall, it's you who will pick me up. No one else'," he says. South Vietnamese women and children wait under the scorching midday sun after being gathered by US Marines for relocation near Da Nang on 7 May 7 1969. Source: AP / Hugh Van Es A peaceful childhood shattered Like Nguyen, Le Quang Vinh never pictured becoming a soldier. The now-78-year-old grew up in the rice fields of the Mekong Delta. His childhood was filled with football, kite flying, and tending his family's buffaloes. That serenity was shattered when the communist forces started appearing in his village at night. "They assassinated our village officer, our teachers ... even killed my dog," Le says. "My dog was innocent. They hit him with a gun and he died in front of me. I felt sorry — even for the animals." Le had once dreamed of becoming a teacher. But by the time he was a teenager, he was fighting for his life and his country. "In our culture, we don't leave. We must stay with our fatherland, and protect our ancestors' graves," he says. "Our spirits were strong because we knew we were fighting for freedom and democracy." Three cherished photos of Le Quang Vinh show him in uniform during his military service, including a moment at the elite Rangers Course in Fort Benning, Georgia, in 1973. Source: SBS News / Christopher Tan On 23 April 1975 — just days before the Fall of Saigon — a rocket exploded 10 metres behind him. "It was a near miss," he recalls. "I was wounded from the fragments and in hospital for a few days, but they rushed me straight back to the front line because we were losing numbers fast." The final hours of Saigon Those final days are seared into Le's soul. On 30 April 1975, his unit was ordered to protect Saigon from the advancing communist forces. Rockets, mortars, and bullets rained from the sky. I saw people with no hands, no legs. A hand, separated from a body, left on the street. It was hell on earth. At 7pm, a soldier handed him a radio. South Vietnam's President Duong Van Minh had surrendered. "I was shocked. I cried. I yelled. I couldn't believe it," Le says. "I looked around and saw soldiers drop their weapons and run. It started raining — just a drizzle — but it felt like the heavens were crying for our country." He later buried fallen comrades in Bien Hoa, including a young lieutenant whose wife jumped into the grave, begging to die with him. "I prayed to God to help us survive. I still cry when I think of that day." Re-education, resistance, and survival Both Le and Nguyen were eventually captured and sent to communist re-education camps — brutal facilities that became known for forced labour, starvation and psychological torment. Le, like many others, was told to attend a camp for a few days, instead he was imprisoned there for three years. "They said it was education, but we didn't learn anything. It was torture," he says. "We dug canals along the Cambodia border. People died [doing so]. "One friend had a bad toothache. They used pliers and there was lots of blood and crying, and he [the friend] told us that if we ever got sick, not to say anything." A North Vietnamese tank rolls through the gate of the Presidential Palace in Saigon, signifying the fall of South Vietnam. Source: AP / DC5 While imprisoned at the camp, Le warned others not to escape. "Those who tried got shot. Their bodies were left on the ground as a warning," he says. "I told my friends, 'You're just escaping a small jail to enter a bigger one'". Even after Le and Nguyen were released from the camp, they were subject to constant surveillance by the Viet Cong. Nguyen's father told him to marry quickly, or risk being imprisoned again. So he did. In 1985, he sold everything he owned for eight pieces of gold — to buy passage to Australia for his wife and two young children. To reach Australian shores — some 4,800km from Vietnam — he and his family would have to make a perilous journey by boat. Thanh Nguyen and Hong Kim Dong on their wedding day in Vietnam, following Nguyen's release from a re-education camp. Source: Supplied / Thanh Nguyen They crammed into the vessel along with more than 80 others. "Everyone had to lie down side-by-side like fish," Nguyen recalls. "It was a very rough ride — the waves were huge, and you could tell the boat wasn't built to handle those conditions." He says they lived in constant fear of encountering Thai pirates, who were known for preying on women and children. "I was so scared for my wife and two young kids," he says. "But luckily, we weren't targeted." The treacherous conditions took a devastating toll. So many people got sick at sea — some even died. We had no choice but to throw the bodies overboard. After surviving the journey, the Nguyens arrived in Malaysia, where they spent three months at Sungei Besi camp on the outskirts of Kuala Lumpur — a facility that felt more like a detention centre — waiting for their refugee applications to be approved. They were eventually resettled in Perth, where they had family already living. "I remember the date we arrived clearly — September 19 1985," Nguyen says. "The very next day, we went straight to work picking strawberries at a farm." Thanh Nguyen with his wife and two children, and others at Sungei Besi camp in Malaysia, 1985. Source: Supplied / Thanh Nguyen Reflecting on the journey, he says: "It was scary and dangerous, but it was better than living without freedom." Risking everything for freedom Le also tried to escape Vietnam by boat. His first attempt ended in disaster when a violent storm struck, capsizing the boat and nearly claiming the lives of his wife and two young children — then-aged three and four — his sister and nephew. "From 1am to 3pm, we fought to survive," Le recounts. "The waves smashed us ... the fuel tank sank and in the end, we drifted back to the same river mouth we came from." Undeterred, he and his family tried again a month later, this time joined by 45 others; mostly women and children. After six harrowing nights at sea, they reached the Malaysian coast. But their initial relief quickly turned to fear. A police boat intercepted them, and an officer asked if anyone could speak English. "I put my hand up," Le says. "He asked me why I wanted to come to Malaysia. I told him: 'Because I know Malaysia is a free country'. He said, 'Malaysia is a communist country too'. I argued: 'I don't think so; you're carrying an American pistol'." Then he pulled it out, pointed it at my head and said, 'You must move back to your country or die here.' A navy vessel arrived, tied up their boat and towed them two hours back out to sea before abandoning them. Le says they spent the rest of the day navigating farther down the coastline until they saw people working on a distant farm. Jagged reefs made it impossible to bring the boat in. "I decided to swim to shore to speak with the farmers, but they only spoke Chinese," he says. With help from an elderly Chinese man on board who acted as interpreter, Le says they were told they could land — but only if they sank the boat and left the area quickly. SBS News 17/08/2023 05:03 That night, Le led the group to a remote shoreline, guided the women and children safely to land, and sank the boat offshore. The next day, he flagged down a car and explained they were refugees with no food or water. Local residents brought biscuits and water and alerted the authorities. The group was then transferred to the overcrowded Kuantan refugee camp. Thanks to Le's strong English, he was appointed camp leader and helped process the paperwork for 645 refugees ahead of a visit by the Australian High Commission. His family was chosen for resettlement in Perth, which ended their five-week ordeal in Malaysia and marked the beginning of their new life in Australia. Australia opens its arms Le and his family were among the first wave of Vietnamese refugees welcomed into Australia under then-Prime Minister Malcolm Fraser's humanitarian resettlement program in 1978. It was a significant turning point in Australian history — coming just five years after the end of the White Australia Policy. "To us, he [Malcolm Fraser] is like a lifesaver," says Carina Hoang, a former refugee and now Special Representative to the UN Refugee Agency. "His decision changed everything. We will always be grateful." Former refugee and UNHCR Special Representative Carina Hoang holds a book she authored, chronicling the powerful stories of Vietnamese refugees. Source: SBS News / Christopher Tan Hoang was just 16 when she fled Vietnam with her two younger siblings. Her father, who was serving in the South Vietnamese military, had been imprisoned without trial for 14 years. After the capture, the communists seized their home. They became homeless overnight. "The day Saigon fell, April 30 1975, changed our lives forever. It was the end of the war ... but the beginning of unimaginable loss," Hoang says. Just one night before, her mother, cousin, and siblings had made it to the US embassy in Saigon. They waited 24 hours for their turn to evacuate in the helicopter — but were told they missed the last one. Mobs of Vietnamese people scale the wall of the US Embassy in Saigon, trying to get to the helicopter pickup zone, just before the end of the Vietnam War on 29 April 1975. Source: AP / Neal Ulevich They walked back home in silence. Hours later, the South Vietnamese government surrendered. Hoang's mother, a parent of seven, couldn't get a job or register a business under the new regime. They tried to leave, but that too was fraught: the family was scammed multiple times by people offering fake boat passages. Hoang says she was once kidnapped and held captive for 30 days by a smuggler they had paid. "When a country is at war, most of the men are out fighting. The women are left to hold everything together," Hoang says. Vietnamese women are strong, resilient — but during the war, they were tested beyond their limits. When she and her family eventually got a boat, their journey across the sea was no easier. "We were chased by pirates; hit by violent storms. At times, we thought no one would make it." A crowded boat of Vietnamese refugees drifts at sea — one of many powerful images featured in Carina Hoang's book documenting the perilous journeys of those who fled Vietnam in search of freedom. Source: SBS News / Christopher Tan Hoang says their boat was shot at on 2 June 1979 by Malaysian authorities and towed back out to sea. Eventually, they docked on an island off Indonesia with no facilities — just jungle. Hoang says over the period of time she was stuck on the island, more than 200 people died of disease and starvation. "More than a million Vietnamese people attempted to flee by boat. It's believed at least a third didn't survive the journey," Hoang says. She and her two siblings were eventually accepted by the United States in 1980, where she faced the challenges of resettlement, learning English and adjusting to a new culture while carrying the emotional weight of having left her family behind. After 26 years in the US, a return trip to Vietnam led her to meet her husband and the couple later settled in Australia in 2016. Finding peace far from home Fifty years on, Hoang, Le and Nguyen are all leading peaceful lives in Perth. They've raised families, found work, and rebuilt what war had torn apart. But the pain remains. "I've never returned to Vietnam," Nguyen says. "Too many sad memories." Thanh Nguyen arrives at Perth International Airport in 1985, with his wife Hong Kim Dong and their three-year-old daughter Thom following close behind — marking the beginning of a new life in Australia. Source: Supplied / Thanh Nguyen While the pain of war did not end with the Fall of Saigon, for those who fled — and those who welcomed them — it also marked new beginnings. Tens of thousands of Vietnamese people came to Australia following the war and as of June last year, there were just under 300,000 Vietnamese-born people living in Australia, according to the Department of Home Affairs. Hoang says behind every resettled Vietnamese family is a story of survival, sacrifice, and unimaginable resilience. "They arrived with nothing — but their values, their strength, and their stories helped shape the multicultural Australia we know today." Thanh Nguyen leads the Vietnam Veterans Association of WA during the 2024 Anzac Day march in Perth. Source: SBS News / Christopher Tan
