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Intensive versus guideline blood pressure and lipid lowering in patients with previous stroke: main results from the pilot ‘Prevention of decline in cognition after stroke trial’ (PODCAST) randomised controlled trial (2017)
Journal Article
Bath, P. M., Scutt, P., Blackburn, D. J., Ankolekar, S., Krishnan, K., Ballard, C., Burns, A., Mant, J., Passmore, P., Pocock, S., Reckless, J., Sprigg, N., Stewart, R., Wardlaw, J. M., & Ford, G. A. (2017). Intensive versus guideline blood pressure and lipid lowering in patients with previous stroke: main results from the pilot ‘Prevention of decline in cognition after stroke trial’ (PODCAST) randomised controlled trial. PLoS ONE, 12(1), Article e0164608. https://doi.org/10.1371/journal.pone.0164608

Background

Stroke is associated with the development of cognitive impairment and dementia. We assessed the effect of intensive blood pressure (BP) and/or lipid lowering on cognitive outcomes in patients with recent stroke in a pilot trial.

Meth... Read More about Intensive versus guideline blood pressure and lipid lowering in patients with previous stroke: main results from the pilot ‘Prevention of decline in cognition after stroke trial’ (PODCAST) randomised controlled trial.

Understanding the relationship between costs and the modified Rankin Scale: a systematic review, multidisciplinary consensus and recommendations for future studies (2016)
Journal Article
Wilson, A., Bath, P. M., Berge, E., Cadilhac, D. A., Cuche, M., Ford, G. A., …Lees, K. R. (2017). Understanding the relationship between costs and the modified Rankin Scale: a systematic review, multidisciplinary consensus and recommendations for future studies. European Stroke Journal, 2(1), https://doi.org/10.1177/2396987316684705

Background and purpose: Cost-of-illness studies often describe a single aggregate cost of a disease state. This approach is less helpful for a condition with a spectrum of outcomes like stroke. The modified Rankin Scale is the most commonly used outc... Read More about Understanding the relationship between costs and the modified Rankin Scale: a systematic review, multidisciplinary consensus and recommendations for future studies.

Dependency and health utilities in stroke: data to inform cost-effectiveness analyses (2016)
Journal Article
Ali, M., MacIsaac, R., Quinn, T. J., Bath, P. M., Veenstra, D. L., Xu, Y., Brady, M. C., Patel, A., & Lees, K. R. (2017). Dependency and health utilities in stroke: data to inform cost-effectiveness analyses. European Stroke Journal, 2(1), https://doi.org/10.1177/2396987316683780

Introduction: Health utilities (HU) assign preference weights to specific health states and are required for costeffectiveness analyses. Existing HU for stroke inadequately reflect the spectrum of post-stroke disability. Using international stroke tr... Read More about Dependency and health utilities in stroke: data to inform cost-effectiveness analyses.

Antiplatelet therapy following ischaemic stroke: continue or change pre-existing therapy? (2016)
Journal Article
Mazlan-Kepli, W., MacIsaac, R. L., Walters, M., Bath, P. M., & Dawson, J. (2017). Antiplatelet therapy following ischaemic stroke: continue or change pre-existing therapy?. European Stroke Journal, 2(1), https://doi.org/10.1177/2396987316678728

Introduction: Antiplatelet therapy is routinely prescribed early after ischaemic stroke. Many patients will already be taking antiplatelet therapy and it is unknown whether these patients should continue the same antiplatelet treatment or switch to a... Read More about Antiplatelet therapy following ischaemic stroke: continue or change pre-existing therapy?.

Baseline characteristics of the 3,096 patients recruited into the 'Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke' (TARDIS) trial (2016)
Journal Article
Bath, P. M., Appleton, J. P., Beridze, M., Christensen, H., Dineen, R. A., Duley, L., …Sprigg, N. (2017). Baseline characteristics of the 3,096 patients recruited into the 'Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke' (TARDIS) trial. International Journal of Stroke, 12(5), 524-538. https://doi.org/10.1177/1747493016677988

Background: The risk of recurrence following ischaemic stroke (IS) or transient ischaemic attack (TIA) is highest immediately after the event. Antiplatelet agents are effective in reducing the risk of recurrence and two agents are superior to one in... Read More about Baseline characteristics of the 3,096 patients recruited into the 'Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke' (TARDIS) trial.

Design and implementation of Pharyngeal electrical Stimulation for early de-cannulation in TRACheotomized (PHAST-TRAC) stroke patients with neurogenic dysphagia: a prospective randomized single-blinded interventional study (2016)
Journal Article
Dziewas, R., Mistry, S., Hamdy, S., Minnerup, J., Van Der Tweel, I., Schäbitz, W., & Bath, P. M. (2017). Design and implementation of Pharyngeal electrical Stimulation for early de-cannulation in TRACheotomized (PHAST-TRAC) stroke patients with neurogenic dysphagia: a prospective randomized single-blinded interventional study. International Journal of Stroke, 12(4), https://doi.org/10.1177/1747493016676618

Rationale: Ongoing dysphagia in stroke patients weaned from mechanical ventilation often requires long-term tracheotomy to protect the airway from aspiration. In a recently reported single-centre pilot study, a significantly larger proportion (75%) o... Read More about Design and implementation of Pharyngeal electrical Stimulation for early de-cannulation in TRACheotomized (PHAST-TRAC) stroke patients with neurogenic dysphagia: a prospective randomized single-blinded interventional study.

Human neural stem cells in patients with chronic ischaemic stroke (PISCES): a phase 1, first-in-man study (2016)
Journal Article
Kalladka, D., Sinden, J., Pollock, K., Haig, C., McLean, J., Smith, W., …Muir, K. W. (2016). Human neural stem cells in patients with chronic ischaemic stroke (PISCES): a phase 1, first-in-man study. Lancet, 388(10046), 787-796. https://doi.org/10.1016/S0140-6736%2816%2930513-X

Background: CTX0E03 is an immortalised human neural stem-cell line from which a drug product (CTX-DP) was developed for allogeneic therapy. Dose-dependent improvement in sensorimotor function in rats implanted with CTX-DP 4 weeks after middle cerebra... Read More about Human neural stem cells in patients with chronic ischaemic stroke (PISCES): a phase 1, first-in-man study.

The Insulin Resistance Intervention after Stroke trial: a perspective on future practice and research (2016)
Journal Article
Bath, P. M., Appleton, J. P., & Sprigg, N. (in press). The Insulin Resistance Intervention after Stroke trial: a perspective on future practice and research. International Journal of Stroke, https://doi.org/10.1177/1747493016660099

The prevention of recurrent events after ischaemic stroke and transient ischaemic attack is well established and based on lifestyle changes, antithrombotics, statins, antihypertensives and carotid surgery. The international IRIS trial assessed whethe... Read More about The Insulin Resistance Intervention after Stroke trial: a perspective on future practice and research.

Pharyngeal electrical stimulation for treatment of dysphagia in subacute stroke (2016)
Journal Article
Bath, P. M., Scutt, P., Love, J., Clavé, P., Cohen, D., Dziewas, R., …Hamdy, S. (in press). Pharyngeal electrical stimulation for treatment of dysphagia in subacute stroke. Stroke, 47(6), https://doi.org/10.1161/STROKEAHA.115.012455

Background and Purpose: Dysphagia is common after stroke, associated with increased death and dependency, and treatment options are limited. Pharyngeal electric stimulation (PES) is a novel treatment for poststroke dysphagia that has shown promise in... Read More about Pharyngeal electrical stimulation for treatment of dysphagia in subacute stroke.

Effect of treatment delay, stroke type, and thrombolysis on the effect of glyceryl trinitrate, a nitric oxide donor, on outcome after acute stroke: a systematic review and meta-analysis of individual patient from randomised trials (2016)
Journal Article
Bath, P. M., Woodhouse, L. J., Krishnan, K., Anderson, C., Berge, E., Ford, G. A., …Wardlaw, J. M. (2016). Effect of treatment delay, stroke type, and thrombolysis on the effect of glyceryl trinitrate, a nitric oxide donor, on outcome after acute stroke: a systematic review and meta-analysis of individual patient from randomised trials. Stroke Research and Treatment, 2016, https://doi.org/10.1155/2016/9706720

Background. Nitric oxide (NO) donors are a candidate treatment for acute stroke and two trials have suggested that they might improve outcome if administered within 4–6 hours of stroke onset. We assessed the safety and efficacy of NO donors using ind... Read More about Effect of treatment delay, stroke type, and thrombolysis on the effect of glyceryl trinitrate, a nitric oxide donor, on outcome after acute stroke: a systematic review and meta-analysis of individual patient from randomised trials.

Baseline characteristics, analysis plan and report on feasibility for the Prevention Of Decline in Cognition After Stroke Trial (PODCAST) (2015)
Journal Article
Scutt, P., Blackburn, D., Krishnan, K., Ballard, C., Burns, A., Ford, G. A., Mant, J., Passmore, P., Pocock, S., Reckless, J., Sprigg, N., Stewart, R., Wardlaw, J. M., & Bath, P. M. (2015). Baseline characteristics, analysis plan and report on feasibility for the Prevention Of Decline in Cognition After Stroke Trial (PODCAST). Trials, 16(1), Article 509. https://doi.org/10.1186/s13063-015-1033-2

Background

A common complication after stroke is development of cognitive impairment and dementia. However, effective strategies for reducing the risk of developing these problems remain undefined. Potential strategies include intensive lowering o... Read More about Baseline characteristics, analysis plan and report on feasibility for the Prevention Of Decline in Cognition After Stroke Trial (PODCAST).

Inhibition of TNF-α protects in vitro brain barrier from ischaemic damage (2015)
Journal Article
Abdullah, Z., Rakkar, K., Bath, P. M., & Bayraktutan, U. (2015). Inhibition of TNF-α protects in vitro brain barrier from ischaemic damage. Molecular and Cellular Neuroscience, 69, https://doi.org/10.1016/j.mcn.2015.11.003

Cerebral ischaemia, associated with neuroinflammation and oxidative stress, is known to perturb blood–brain barrier (BBB) integrity and promote brain oedema formation. Using an in vitro model of human BBB composed of brain microvascular endothelial c... Read More about Inhibition of TNF-α protects in vitro brain barrier from ischaemic damage.

Pharmacological treatment and prevention of cerebral small vessel disease: a review of potential interventions (2015)
Journal Article
Bath, P. M., & Wardlaw, J. M. (2015). Pharmacological treatment and prevention of cerebral small vessel disease: a review of potential interventions. International Journal of Stroke, 10(4), https://doi.org/10.1111/ijs.12466

Small vessel disease encompasses lacunar stroke, white matter hyperintensities, lacunes and microbleeds. It causes a quarter of all ischemic strokes, is the commonest cause of vascular dementia, and the cause is incompletely understood. Vascular prop... Read More about Pharmacological treatment and prevention of cerebral small vessel disease: a review of potential interventions.

Performance characteristics of methods for quantifying spontaneous intracerebral haemorrhage: data from the Efficacy of Nitric Oxide in Stroke (ENOS) trial (2015)
Journal Article

Background: Poor prognosis after intracerebral haemorrhage (ICH) is related to haemorrhage characteristics. Along with developing therapeutic interventions, we sought to understand the performance of haemorrhage descriptors in large clinical trials.... Read More about Performance characteristics of methods for quantifying spontaneous intracerebral haemorrhage: data from the Efficacy of Nitric Oxide in Stroke (ENOS) trial.

Statistical analysis plan for the ‘Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke’ (TARDIS) trial (2014)
Journal Article
Bath, P. M., Robson, K., Woodhouse, L. J., Sprigg, N., Dineen, R. A., & Pocock, S. J. (2015). Statistical analysis plan for the ‘Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke’ (TARDIS) trial. International Journal of Stroke, 10(3), https://doi.org/10.1111/ijs.12445

Rationale: Antiplatelet agents such as aspirin, clopidogrel and dipyridamole are effective in reducing the risk of recurrence after a stroke. Importantly, the risk of recurrence is highest immediately after the index event while antiplatelets cause b... Read More about Statistical analysis plan for the ‘Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke’ (TARDIS) trial.

Interventions for deliberately altering blood pressure in acute stroke (2014)
Journal Article
Bath, P. M., & Krishnan, K. (2014). Interventions for deliberately altering blood pressure in acute stroke. Cochrane Database of Systematic Reviews, 2014(10), Article CD000039. https://doi.org/10.1002/14651858.CD000039.pub3

Background: It is unclear whether blood pressure should be altered actively during the acute phase of stroke. This is an update of a Cochrane review first published in 1997, and previously updated in 2001 and 2008.
Objectives: To assess the clinical... Read More about Interventions for deliberately altering blood pressure in acute stroke.

Efficacy of nitric oxide, with or without continuing antihypertensive treatment, for management of high blood pressure in acute stroke (ENOS): a partial-factorial randomised controlled trial (2014)
Journal Article
Bath, P. M. (2015). Efficacy of nitric oxide, with or without continuing antihypertensive treatment, for management of high blood pressure in acute stroke (ENOS): a partial-factorial randomised controlled trial. Lancet, 385(9968), https://doi.org/10.1016/S0140-6736%2814%2961121-1

Background

High blood pressure is associated with poor outcome after stroke. Whether blood pressure should be lowered early after stroke, and whether to continue or temporarily withdraw existing antihypertensive drugs, is not known. We assessed ou... Read More about Efficacy of nitric oxide, with or without continuing antihypertensive treatment, for management of high blood pressure in acute stroke (ENOS): a partial-factorial randomised controlled trial.

Testing devices for the prevention and treatment of stroke and its complications (2014)
Journal Article
Bath, P. M., Brainin, M., Brown, C., Campbell, B., Davis, S. M., Donnan, G. A., …Truelsen, T. (in press). Testing devices for the prevention and treatment of stroke and its complications. International Journal of Stroke, 9(6), https://doi.org/10.1111/ijs.12302

We are entering a challenging but exciting period when many new interventions may appear for stroke based on the use of devices. Hopefully these will lead to improved outcomes at a cost that can be afforded in most parts of the world. Nevertheless, i... Read More about Testing devices for the prevention and treatment of stroke and its complications.

Tranexamic acid for spontaneous intracerebral hemorrhage: a randomized controlled pilot trial (ISRCTN50867461) (2014)
Journal Article
a randomized controlled pilot trial (ISRCTN50867461). Journal of Stroke and Cerebrovascular Diseases, 23(6), 1312-1318. https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.11.007

Background: Spontaneous intracerebral hemorrhage (ICH) can be devastating, particularly if hematoma expansion (HE) occurs. Tranexamic acid (TA), an antifibrinolytic drug, significantly reduced mortality in bleeding patients after trauma in the large... Read More about Tranexamic acid for spontaneous intracerebral hemorrhage: a randomized controlled pilot trial (ISRCTN50867461).