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Prehospital transdermal glyceryl trinitrate for ultra-acute ischaemic stroke: data from the RIGHT-2 randomised sham-controlled ambulance trial (2023)
Journal Article
Appleton, J. P., Woodhouse, L. J., Anderson, C. S., Ankolekar, S., Cala, L., Dixon, M., …Bath, P. M. (2023). Prehospital transdermal glyceryl trinitrate for ultra-acute ischaemic stroke: data from the RIGHT-2 randomised sham-controlled ambulance trial. Stroke and Vascular Neurology, 9(1), https://doi.org/10.1136/svn-2022-001634

Background The effect of transdermal glyceryl trinitrate (GTN, a nitrovasodilator) on clinical outcome when administered before hospital admission in suspected stroke patients is unclear. Here, we assess the safety and efficacy of GTN in the prespeci... Read More about Prehospital transdermal glyceryl trinitrate for ultra-acute ischaemic stroke: data from the RIGHT-2 randomised sham-controlled ambulance trial.

Endovascular Thrombectomy vs Best Medical Therapy for Late Presentation Acute Ischaemic Stroke with Proximal Large Vessel Occlusion Selected Based on Non-Contrast CT: A Retrospective Analysis of Two Prospectively Defined Cohorts (2022)
Journal Article
Singh Dhillon, P., Butt, W., Jovin, T. G., Podlasek, A., McConachie, N., Lenthall, R., …England, T. J. (2023). Endovascular Thrombectomy vs Best Medical Therapy for Late Presentation Acute Ischaemic Stroke with Proximal Large Vessel Occlusion Selected Based on Non-Contrast CT: A Retrospective Analysis of Two Prospectively Defined Cohorts. Stroke: Vascular and Interventional Neurology, 3(2), Article e000686. https://doi.org/10.1161/SVIN.122.000686

Background: The efficacy and safety of endovascular thrombectomy (EVT) beyond 6 hours from acute ischaemic stroke (AIS) onset for patients selected without CT perfusion or MR imaging is undetermined in routine clinical practice. Methods: In this... Read More about Endovascular Thrombectomy vs Best Medical Therapy for Late Presentation Acute Ischaemic Stroke with Proximal Large Vessel Occlusion Selected Based on Non-Contrast CT: A Retrospective Analysis of Two Prospectively Defined Cohorts.

Dietary nitrate supplementation for preventing and reducing the severity of winter infections, including COVID-19, in care homes (BEET-Winter)-a randomised placebo-controlled feasibility trial (2022)
Journal Article
Bath, P. M., Skinner, C. J. C., Bath, C. S., Woodhouse, L. J., Areti, A., Korovesi, K., …Gordon, A. L. (2022). Dietary nitrate supplementation for preventing and reducing the severity of winter infections, including COVID-19, in care homes (BEET-Winter)-a randomised placebo-controlled feasibility trial. European Geriatric Medicine, 13, 1343-1355. https://doi.org/10.1007/s41999-022-00714-5

Purpose Infections cause considerable care home morbidity and mortality. Nitric oxide (NO) has broad-spectrum anti-viral, bacterial and yeast activity in vitro. We assessed the feasibility of supplementing dietary nitrate (NO substrate) intake in ca... Read More about Dietary nitrate supplementation for preventing and reducing the severity of winter infections, including COVID-19, in care homes (BEET-Winter)-a randomised placebo-controlled feasibility trial.

Effect of Tranexamic Acid Administration on Remote Cerebral Ischemic Lesions in Acute Spontaneous Intracerebral Hemorrhage: A Substudy of a Randomized Clinical Trial (2022)
Journal Article
Pszczolkowski, S., Sprigg, N., Woodhouse, L. J., Gallagher, R., Swienton, D., Law, Z. K., …Dineen, R. A. (2022). Effect of Tranexamic Acid Administration on Remote Cerebral Ischemic Lesions in Acute Spontaneous Intracerebral Hemorrhage: A Substudy of a Randomized Clinical Trial. JAMA Neurology, 79(5), 468-477. https://doi.org/10.1001/jamaneurol.2022.0217

Importance: Hyperintense foci on diffusion-weighted imaging (DWI) that are spatially remote from the acute hematoma occur in 20% of people with acute spontaneous intracerebral hemorrhage (ICH). Tranexamic acid, a hemostatic agent that is under invest... Read More about Effect of Tranexamic Acid Administration on Remote Cerebral Ischemic Lesions in Acute Spontaneous Intracerebral Hemorrhage: A Substudy of a Randomized Clinical Trial.

Association between time to treatment and clinical outcomes in endovascular thrombectomy beyond 6 hours without advanced imaging selection (2022)
Journal Article
Dhillon, P. S., Butt, W., Podlasek, A., McConachie, N., Lenthall, R., Nair, S., …England, T. J. (2023). Association between time to treatment and clinical outcomes in endovascular thrombectomy beyond 6 hours without advanced imaging selection. Journal of NeuroInterventional Surgery, 15(4), 336-342. https://doi.org/10.1136/neurintsurg-2021-018564

Background: The effectiveness and safety of endovascular thrombectomy (EVT) in the late window (6-24 hours) for acute ischemic stroke (AIS) patients selected without advanced imaging is undetermined. We aimed to assess clinical outcomes and the relat... Read More about Association between time to treatment and clinical outcomes in endovascular thrombectomy beyond 6 hours without advanced imaging selection.

Endovascular thrombectomy beyond 24 hours from ischemic stroke onset: A propensity score matched cohort study (2022)
Journal Article
Singh Dhillon, P., Butt, W., Podlasek, A., Barrett, E., McConachie, N., Lenthall, R., …England, T. J. (2023). Endovascular thrombectomy beyond 24 hours from ischemic stroke onset: A propensity score matched cohort study. Journal of NeuroInterventional Surgery, 15(3), 233-237. https://doi.org/10.1136/neurintsurg-2021-018591

Background: The safety and functional outcome of endovascular thrombectomy (EVT) in the very late (VL; >24 hours) time window from ischemic stroke onset remains undetermined. Methods: Using data from a national stroke registry, we used propensity sco... Read More about Endovascular thrombectomy beyond 24 hours from ischemic stroke onset: A propensity score matched cohort study.

Pre-hospital transdermal glyceryl trinitrate in patients with stroke mimics: data from the RIGHT-2 randomised-controlled ambulance trial (2022)
Journal Article
Tunnage, B., Woodhouse, L. J., Dixon, M., Anderson, C. S., Ankolekar, S., Appleton, J. P., …Bath, P. M. (2022). Pre-hospital transdermal glyceryl trinitrate in patients with stroke mimics: data from the RIGHT-2 randomised-controlled ambulance trial. BMC Emergency Medicine, 22(1), Article 2. https://doi.org/10.1186/s12873-021-00560-x

Background: Prehospital stroke trials will inevitably recruit patients with non-stroke conditions, so called stroke mimics. We undertook a pre-specified analysis to determine outcomes in patients with mimics in the second Rapid Intervention with Glyc... Read More about Pre-hospital transdermal glyceryl trinitrate in patients with stroke mimics: data from the RIGHT-2 randomised-controlled ambulance trial.

Brief Consent Methods Enable Rapid Enrollment in Acute Stroke Trial: Results From the TICH-2 Randomized Controlled Trial (2021)
Journal Article
the TICH-2 Investigators, Law, Z. K., Appleton, J. P., Scutt, P., Roberts, I., Al-Shahi Salman, R., …Sprigg, N. (2021). Brief Consent Methods Enable Rapid Enrollment in Acute Stroke Trial: Results From the TICH-2 Randomized Controlled Trial. Stroke, 53(4), 1141-1148. https://doi.org/10.1161/STROKEAHA.121.035191

Background: Seeking consent rapidly in acute stroke trials is crucial as interventions are time sensitive. We explored the association between consent pathways and time to enrollment in the TICH-2 (Tranexamic Acid in Intracerebral Haemorrhage-2) rand... Read More about Brief Consent Methods Enable Rapid Enrollment in Acute Stroke Trial: Results From the TICH-2 Randomized Controlled Trial.

Diagnostic accuracy of the Dysphagia Trained Nurse Assessment tool in acute stroke (2021)
Journal Article
Benfield, J. K., Wilkinson, G., Everton, L. F., Bath, P. M., & England, T. J. (2021). Diagnostic accuracy of the Dysphagia Trained Nurse Assessment tool in acute stroke. European Journal of Neurology, 28(8), 2766-2774. https://doi.org/10.1111/ene.14900

Background and purpose Comprehensive swallow screening assessments to identify dysphagia and make early eating and drinking recommendations can be used by trained nurses. This study aimed to validate the Dysphagia Trained Nurse Assessment (DTNAx) to... Read More about Diagnostic accuracy of the Dysphagia Trained Nurse Assessment tool in acute stroke.

Outcomes in Antiplatelet?Associated Intracerebral Hemorrhage in the TICH?2 Randomized Controlled Trial (2021)
Journal Article
Law, Z. K., Desborough, M., Roberts, I., Al‐Shahi Salman, R., England, T. J., Werring, D. J., …Sprigg, N. (2021). Outcomes in Antiplatelet‐Associated Intracerebral Hemorrhage in the TICH‐2 Randomized Controlled Trial. Journal of the American Heart Association, 10(5), Article e019130. https://doi.org/10.1161/jaha.120.019130

Background Antiplatelet therapy increases the risk of hematoma expansion in intracerebral hemorrhage (ICH) while the effect on functional outcome is uncertain. Methods and Results This is an exploratory analysis of the TICH‐2 (Tranexamic Acid in... Read More about Outcomes in Antiplatelet?Associated Intracerebral Hemorrhage in the TICH?2 Randomized Controlled Trial.

Blood markers in remote ischaemic conditioning for acute ischaemic stroke: data from the REmote ischaemic Conditioning After Stroke Trial (2020)
Journal Article
Appleton, J. P., O'Sullivan, S. E., Hedstrom, A., May, J. A., Donnelly, R., Sprigg, N., …England, T. J. (2021). Blood markers in remote ischaemic conditioning for acute ischaemic stroke: data from the REmote ischaemic Conditioning After Stroke Trial. European Journal of Neurology, 28(4), 1225-1233. https://doi.org/10.1111/ene.14650

Background and purpose: Remote ischaemic per-conditioning (RIC) is neuroprotective in experimental ischaemic stroke. Several neurohumoral, vascular and inflammatory mediators are implicated. The effect of RIC on plasma biomarkers was assessed using c... Read More about Blood markers in remote ischaemic conditioning for acute ischaemic stroke: data from the REmote ischaemic Conditioning After Stroke Trial.

Predictors and outcomes of neurological deterioration in intracerebral hemorrhage: results from the TICH-2 randomised controlled trial (2020)
Journal Article
Kang Law, Z., Dineen, R., England, T. J., Cala, L., Mistri, A. K., Appleton, J. P., …TICH-2 investigators. (2021). Predictors and outcomes of neurological deterioration in intracerebral hemorrhage: results from the TICH-2 randomised controlled trial. Translational Stroke Research, 12, 275-283. https://doi.org/10.1007/s12975-020-00845-6

Neurological deterioration is common after intracerebral hemorrhage (ICH). We aimed to identify the predictors and effects of neurological deterioration and whether tranexamic acid reduced the risk of neurological deterioration. Data from the Tranexa... Read More about Predictors and outcomes of neurological deterioration in intracerebral hemorrhage: results from the TICH-2 randomised controlled trial.

The Landscape of Videofluoroscopy in the UK: A Web-Based Survey (2020)
Journal Article
Benfield, J. K., Michou, E., Everton, L. F., Mills, C., Hamdy, S., Bath, P. M., & England, T. J. (2020). The Landscape of Videofluoroscopy in the UK: A Web-Based Survey. Dysphagia, https://doi.org/10.1007/s00455-020-10130-1

Videofluoroscopy (VFS) is considered one of the gold-standard assessments of swallowing. Whilst guidelines for the application and conduct of VFS exist, their translation into clinical practice remain challenging. To build a greater understanding on... Read More about The Landscape of Videofluoroscopy in the UK: A Web-Based Survey.

Psychometric assessment and validation of the dysphagia severity rating scale in stroke patients (2020)
Journal Article
Everton, L. F., Benfield, J. K., Hedstrom, A., Wilkinson, G., Michou, E., England, T. J., …Hamdy, S. (2020). Psychometric assessment and validation of the dysphagia severity rating scale in stroke patients. Scientific Reports, 10, Article 7268. https://doi.org/10.1038/s41598-020-64208-9

Post stroke dysphagia (PSD) is common and associated with poor outcome. The Dysphagia Severity Rating Scale (DSRS), which grades how severe dysphagia is based on fluid and diet modification and supervision requirements for feeding, is used for clinic... Read More about Psychometric assessment and validation of the dysphagia severity rating scale in stroke patients.

Protocol: The Lacunar Intervention Trial 2 (LACI-2). A trial of two repurposed licenced drugs to prevent progression of cerebral small vessel disease (2020)
Journal Article
Wardlaw, J., Bath, P. M., Doubal, F., Heye, A., Sprigg, N., Woodhouse, L. J., …The LACI-2 Trial Investigators. (2020). Protocol: The Lacunar Intervention Trial 2 (LACI-2). A trial of two repurposed licenced drugs to prevent progression of cerebral small vessel disease. European Stroke Journal, 5(3), 297-308. https://doi.org/10.1177/2396987320920110

Background Small vessel disease causes a quarter of ischaemic strokes (lacunar subtype), up to 45% of dementia either as vascular or mixed types, cognitive impairment and physical frailty. However, there is no specific treatment to prevent progressi... Read More about Protocol: The Lacunar Intervention Trial 2 (LACI-2). A trial of two repurposed licenced drugs to prevent progression of cerebral small vessel disease.

Incidence and predictors of early seizures in intracerebral haemorrhage and the effect of tranexamic acid (2020)
Journal Article
Law, Z. K., England, T. J., Mistri, A. K., Woodhouse, L. J., Cala, L., Dineen, R., …TICH-2 investigators. (2020). Incidence and predictors of early seizures in intracerebral haemorrhage and the effect of tranexamic acid. European Stroke Journal, 5(2), 123-129. https://doi.org/10.1177/2396987320901391

Introduction: Seizures are common after intracerebral haemorrhage. Tranexamic acid increases the risk of seizures in non-intracerebral haemorrhage population but its effect on post-intracerebral haemorrhage seizures is unknown. We explored the risk f... Read More about Incidence and predictors of early seizures in intracerebral haemorrhage and the effect of tranexamic acid.

Accuracy and clinical utility of comprehensive dysphagia screening assessments in acute stroke: A systematic review and meta?analysis (2020)
Journal Article
Benfield, J. K., Everton, L. F., Bath, P. M., & England, T. J. (2020). Accuracy and clinical utility of comprehensive dysphagia screening assessments in acute stroke: A systematic review and meta?analysis. Journal of Clinical Nursing, 29(9-10), 1527-1538. https://doi.org/10.1111/jocn.15192

Introduction Nurses and other nonspecialists in dysphagia are often trained to screen swallowing poststroke. There are many basic tools that test water only, they are usually conservative, and patients that fail the test remain nil by mouth until... Read More about Accuracy and clinical utility of comprehensive dysphagia screening assessments in acute stroke: A systematic review and meta?analysis.

Noncontrast Computed Tomography Signs as Predictors of Hematoma Expansion, Clinical Outcome and Response to Tranexamic Acid in Acute Intracerebral Hemorrhage (2019)
Journal Article
Law, Z. K., Ali, A., Krishnan, K., Bischoff, A., Appleton, J., Scutt, P., …Sprigg, N. (2020). Noncontrast Computed Tomography Signs as Predictors of Hematoma Expansion, Clinical Outcome and Response to Tranexamic Acid in Acute Intracerebral Hemorrhage. Stroke, 51(1), 121–128. https://doi.org/10.1161/STROKEAHA.119.026128

Background and purpose Blend, black hole and island signs and hypodensities are reported to predict hematoma expansion in acute intracerebral hemorrhage (ICH). We explored the value of these noncontrast CT (NCCT) signs in predicting hematoma expan... Read More about Noncontrast Computed Tomography Signs as Predictors of Hematoma Expansion, Clinical Outcome and Response to Tranexamic Acid in Acute Intracerebral Hemorrhage.

Prehospital Transdermal Glyceryl Trinitrate for Ultra-Acute Intracerebral Hemorrhage (2019)
Journal Article
Bath, P. M., Woodhouse, L. J., Krishnan, K., Appleton, J. P., Anderson, C. S., Berge, E., …Sprigg, N. (2019). Prehospital Transdermal Glyceryl Trinitrate for Ultra-Acute Intracerebral Hemorrhage. Stroke, 50(11), 3064-3071. https://doi.org/10.1161/STROKEAHA.119.026389

Background and Purpose— Pilot trials suggest that glyceryl trinitrate (GTN; nitroglycerin) may improve outcome when administered early after stroke onset. Methods— We undertook a multicentre, paramedic-delivered, ambulance-based, prospective ran... Read More about Prehospital Transdermal Glyceryl Trinitrate for Ultra-Acute Intracerebral Hemorrhage.