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The Hazard of Negative (Not Neutral) Trials on Treatment of Acute Stroke: A Review (2019)
Journal Article
Bath, P. M., Appleton, J. P., & England, T. (2020). The Hazard of Negative (Not Neutral) Trials on Treatment of Acute Stroke: A Review. JAMA Neurology, 77(1), 114-124. https://doi.org/10.1001/jamaneurol.2019.4107

Importance: While there are a limited number of beneficial treatments for acute stroke (eg, stroke units, reperfusion, aspirin, hemicraniectomy), there are more negative (as opposed to neutral) interventions spanning multiple different mechanisms of... Read More about The Hazard of Negative (Not Neutral) Trials on Treatment of Acute Stroke: A Review.

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.

Multi-level community interventions for primary stroke prevention: A conceptual approach by the World Stroke Organization (2019)
Journal Article
Brainin, M., Feigin, V., Bath, P. M., Collantes, E., Martins, S., Pandian, J., …Teuschl, Y. (2019). Multi-level community interventions for primary stroke prevention: A conceptual approach by the World Stroke Organization. International Journal of Stroke, 14(8), 818-825. https://doi.org/10.1177/1747493019873706

The increasing burden of stroke and dementia emphasizes the need for new, well-tolerated and cost-effective primary prevention strategies that can reduce the risks of stroke and dementia worldwide, and specifically in low- and middle-income countries... Read More about Multi-level community interventions for primary stroke prevention: A conceptual approach by the World Stroke Organization.

Effects of Isosorbide Mononitrate and/or Cilostazol on Hematological Markers, Platelet Function, and Hemodynamics in Patients With Lacunar Ischaemic Stroke: Safety Data From the Lacunar Intervention-1 (LACI-1) Trial (2019)
Journal Article
Appleton, J., Blair, G. W., Flaherty, K., Law, Z., May, J., Woodhouse, L. J., …Wardlow, J. M. (2019). Effects of Isosorbide Mononitrate and/or Cilostazol on Hematological Markers, Platelet Function, and Hemodynamics in Patients With Lacunar Ischaemic Stroke: Safety Data From the Lacunar Intervention-1 (LACI-1) Trial. Frontiers in Neurology, 10, 1-6. https://doi.org/10.3389/fneur.2019.00723

Background Cilostazol and isosorbide mononitrate (ISMN) are candidate treatments for cerebral small vessel disease and lacunar ischaemic stroke. As both drugs may influence haemoglobin and platelet count, and haemodynamics, we sought to assess their... Read More about Effects of Isosorbide Mononitrate and/or Cilostazol on Hematological Markers, Platelet Function, and Hemodynamics in Patients With Lacunar Ischaemic Stroke: Safety Data From the Lacunar Intervention-1 (LACI-1) Trial.

Associations between change in blood pressure and functional outcome, early events and death: results from the Efficacy of Nitric Oxide in Stroke trial (2019)
Journal Article
Sandset, E. C., Appleton, J. P., Berge, E., Christensen, H., Gommans, J., Krishnan, K., …Bath, P. M. (2019). Associations between change in blood pressure and functional outcome, early events and death: results from the Efficacy of Nitric Oxide in Stroke trial. Journal of Hypertension, 37(10), 2104-2109. https://doi.org/10.1097/HJH.0000000000002154

Objectives: High blood pressure (BP) is associated with a poor outcome after acute stroke. Early reduction in blood pressure (BP) may be associated with fewer early adverse events and deaths, and improved functional outcome. Methods: Analyses used d... Read More about Associations between change in blood pressure and functional outcome, early events and death: results from the Efficacy of Nitric Oxide in Stroke trial.

Tranexamic acid to improve functional status in adults with spontaneous intracerebral haemorrhage: the TICH-2 RCT (2019)
Journal Article
Sprigg, N., Flaherty, K., Appleton, J. P., Al-Shahi Salman, R., Bereczki, D., Beridze, M., …Bath, P. M. (2019). Tranexamic acid to improve functional status in adults with spontaneous intracerebral haemorrhage: the TICH-2 RCT. Health Technology Assessment, 23(35), 1-48. https://doi.org/10.3310/hta23350

BACKGROUND: Tranexamic acid reduces death due to bleeding after trauma and postpartum haemorrhage. OBJECTIVE: The aim of the study was to assess if tranexamic acid is safe, reduces haematoma expansion and improves outcomes in adults with spontaneous... Read More about Tranexamic acid to improve functional status in adults with spontaneous intracerebral haemorrhage: the TICH-2 RCT.

The effectiveness and safety of anti-fibrinolytics in patients with acute intracranial haemorrhage: statistical analysis plan for an individual patient data meta-analysis [version 3; peer review: 2 approved] (2019)
Journal Article
Ker, K., Prieto-Merino, D., Sprigg, N., Mahmood, A., Bath, P., Kang Law, Z., …Roberts, I. (2019). The effectiveness and safety of anti-fibrinolytics in patients with acute intracranial haemorrhage: statistical analysis plan for an individual patient data meta-analysis [version 3; peer review: 2 approved]. Wellcome Open Research, Article 120. https://doi.org/10.12688/wellcomeopenres.13262.3

Introduction: The Anti-fibrinolytics Trialists Collaboration aims to increase knowledge about the effectiveness and safety of anti-fibrinolytic treatment by conducting individual patient data (IPD) meta-analyses of randomised trials. This article pre... Read More about The effectiveness and safety of anti-fibrinolytics in patients with acute intracranial haemorrhage: statistical analysis plan for an individual patient data meta-analysis [version 3; peer review: 2 approved].

Antiplatelet Therapy After Noncardioembolic Stroke: An Individual Patient Data Network Meta-Analysis (2019)
Journal Article
Greving, J. P., Diener, H., Reitsma, J., Bath, P., Csiba, L., Hacke, W., …Algra, A. (2019). Antiplatelet Therapy After Noncardioembolic Stroke: An Individual Patient Data Network Meta-Analysis. Stroke, 50(7), 1812-1818. https://doi.org/10.1161/strokeaha.118.024497

© 2019 American Heart Association, Inc. Background and Purpose-We assessed the efficacy and safety of antiplatelet agents after noncardioembolic stroke or transient ischemic attack and examined how these vary according to patients' demographic and cl... Read More about Antiplatelet Therapy After Noncardioembolic Stroke: An Individual Patient Data Network Meta-Analysis.

Outcome Assessment by Central Adjudicators Versus Site Investigators in Stroke Trials: A Systematic Review and Meta-Analysis (2019)
Journal Article
Godolphin, P. J., Bath, P. M., Algra, A., Berge, E., Brown, M. M., Chalmers, J., …on behalf of the Adjudicating Outcomes in Stroke Trials Collaboration*. (2019). Outcome Assessment by Central Adjudicators Versus Site Investigators in Stroke Trials: A Systematic Review and Meta-Analysis. Stroke, 50(8), 2187-2196. https://doi.org/10.1161/strokeaha.119.025019

© 2019 American Heart Association, Inc. Background and Purpose-In randomized stroke trials, central adjudication of a trial's primary outcome is regularly implemented. However, recent evidence questions the importance of central adjudication in rando... Read More about Outcome Assessment by Central Adjudicators Versus Site Investigators in Stroke Trials: A Systematic Review and Meta-Analysis.

Tolerability, safety and intermediary pharmacological effects of cilostazol and isosorbide mononitrate, alone and combined, in patients with lacunar ischaemic stroke: the LACunar Intervention-1 (LACI-1) trial, a randomised clinical trial (2019)
Journal Article
Blair, G. W., Appleton, J. P., Flaherty, K., Doubal, F., Sprigg, N., Dooley, R., …Wardlaw, J. M. (2019). Tolerability, safety and intermediary pharmacological effects of cilostazol and isosorbide mononitrate, alone and combined, in patients with lacunar ischaemic stroke: the LACunar Intervention-1 (LACI-1) trial, a randomised clinical trial. EClinicalMedicine, 11, 34-43. https://doi.org/10.1016/j.eclinm.2019.04.001

Background Lacunar stroke, a frequent clinical manifestation of small vessel disease (SVD), differs pathologically from other ischaemic stroke subtypes and has no specific long-term secondary prevention. Licenced drugs, isosorbide mononitrate (ISMN)... Read More about Tolerability, safety and intermediary pharmacological effects of cilostazol and isosorbide mononitrate, alone and combined, in patients with lacunar ischaemic stroke: the LACunar Intervention-1 (LACI-1) trial, a randomised clinical trial.

Posterior circulation stroke diagnosis using HINTS in patients presenting with acute vestibular syndrome: A systematic review (2019)
Journal Article
Krishnan, K., Bassilious, K., Eriksen, E., Bath, P. M., Sprigg, N., Brækken, S. K., …Sandset, E. C. (2019). Posterior circulation stroke diagnosis using HINTS in patients presenting with acute vestibular syndrome: A systematic review. European Stroke Journal, 4(3), 233-239. https://doi.org/10.1177/2396987319843701

Purpose Acute vestibular syndrome – vertigo, nausea/vomiting, nystagmus and gait unsteadiness – is common, and differentiating posterior circulation stroke from a peripheral cause can be challenging. The National Institute of Health Stroke Scale (NI... Read More about Posterior circulation stroke diagnosis using HINTS in patients presenting with acute vestibular syndrome: A systematic review.

Applicability of ENCHANTED trial results to current acute ischemic stroke patients eligible for intravenous thrombolysis in England and Wales: Comparison with the Sentinel Stroke National Audit Programme registry (2019)
Journal Article
S Anderson, C., Robinson, T. G., Bray, B. D., Paley, L., Sprigg, N., Wang, X., …for the ENCHANTED Investigators and the SSNAP Collaboration. (2019). Applicability of ENCHANTED trial results to current acute ischemic stroke patients eligible for intravenous thrombolysis in England and Wales: Comparison with the Sentinel Stroke National Audit Programme registry. International Journal of Stroke, 14(7), 678-685. https://doi.org/10.1177/1747493019841246

© 2019 World Stroke Organization. Background: Randomized controlled trials provide high-level evidence, but the necessity to include selected patients may limit the generalisability of their results. Methods: Comparisons were made of baseline and out... Read More about Applicability of ENCHANTED trial results to current acute ischemic stroke patients eligible for intravenous thrombolysis in England and Wales: Comparison with the Sentinel Stroke National Audit Programme registry.

14th International Symposium on Thrombolysis, Thrombectomy and Acute Stroke Therapy: proceedings and summary of discussions (2019)
Journal Article
Sheth, S. A., Lopez-Rivera, V., Lee, S., Savitz, S. I., Liebeskind, D. S., Grotta, J. C., …Bath, P. (2019). 14th International Symposium on Thrombolysis, Thrombectomy and Acute Stroke Therapy: proceedings and summary of discussions. International Journal of Stroke, 14(4), 439-441. https://doi.org/10.1177/1747493019838760

The 14th International Symposium on Thrombolysis, Thrombectomy and Acute Stroke Therapy (TTST) took place in Houston, Texas on 21–22 October 2018. Attended by 150þ invited global experts, the objectives of TTST 2018 were to explore the changing lands... Read More about 14th International Symposium on Thrombolysis, Thrombectomy and Acute Stroke Therapy: proceedings and summary of discussions.

Cerebellar repetitive transcranial magnetic stimulation restores pharyngeal brain activity and swallowing behaviour after disruption by a cortical virtual lesion (2019)
Journal Article
Sasegbon, A., Watanabe, M., Simons, A., Michou, E., Vasant, D. H., Magara, J., …Hamdy, S. (2019). Cerebellar repetitive transcranial magnetic stimulation restores pharyngeal brain activity and swallowing behaviour after disruption by a cortical virtual lesion. Journal of Physiology, 597(9), 2533-2546. https://doi.org/10.1113/jp277545

Repetitive transcranial magnetic stimulation (rTMS) can alter neuronal activity within the brain with therapeutic potential. Low frequency stimulation to the ‘dominant’ cortical swallowing projection induces a ‘virtual‐lesion’ transiently suppressing... Read More about Cerebellar repetitive transcranial magnetic stimulation restores pharyngeal brain activity and swallowing behaviour after disruption by a cortical virtual lesion.

It is safe to use transdermal glyceryl trinitrate to lower blood pressure in patients with acute ischaemic stroke with carotid stenosis (2019)
Journal Article
Appleton, J. P., Woodhouse, L. J., Belcher, A., Bereczki, D., Berge, E., Caso, V., …Bath, P. M. (2019). It is safe to use transdermal glyceryl trinitrate to lower blood pressure in patients with acute ischaemic stroke with carotid stenosis. Stroke and Vascular Neurology, 4(1), 28-35. https://doi.org/10.1136/svn-2019-000232

Background There is concern that blood pressure (BP) lowering in acute stroke may compromise cerebral perfusion and worsen outcome in the presence of carotid stenosis. We assessed the effect of glyceryl trinitrate (GTN) in patients with carotid steno... Read More about It is safe to use transdermal glyceryl trinitrate to lower blood pressure in patients with acute ischaemic stroke with carotid stenosis.

Intensive blood pressure reduction with intravenous thrombolysis therapy for acute ischaemic stroke (ENCHANTED): an international randomised, open-label, blinded-endpoint phase 3 trial (2019)
Journal Article
Anderson, C. S., Huang, Y., Lindley, R. I., Chen, X., Arima, H., Chen, G., …ENCHANTED Investigators and Coordinators. (2019). Intensive blood pressure reduction with intravenous thrombolysis therapy for acute ischaemic stroke (ENCHANTED): an international randomised, open-label, blinded-endpoint phase 3 trial. Lancet, 393(10174), 877-888. https://doi.org/10.1016/S0140-6736%2819%2930038-8

Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomised, sham-controlled, blinded, phase 3 trial (2019)
Journal Article
Bath, P. M., Scutt, P., Anderson, C. S., Appleton, J. P., Berge, E., Cala, L., …Mir, R. (2019). Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomised, sham-controlled, blinded, phase 3 trial. Lancet, 393(10175), 1009-1020. https://doi.org/10.1016/S0140-6736%2819%2930194-1

© 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: High blood pressure is common in acute stroke and is a predictor of poor outcome; however, large trials of lowering blood pressure... Read More about Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomised, sham-controlled, blinded, phase 3 trial.

Short email with attachment versus long email without attachment when contacting authors to request unpublished data for a systematic review: a nested randomised trial (2019)
Journal Article
Godolphin, P. J., Bath, P. M., & Montgomery, A. A. (2019). Short email with attachment versus long email without attachment when contacting authors to request unpublished data for a systematic review: a nested randomised trial. BMJ Open, 9(1), Article e25273. https://doi.org/10.1136/bmjopen-2018-025273

Objective: Systematic reviews often rely on the acquisition of unpublished analyses or data. We carried out a nested randomised trial comparing two different approaches for contacting authors to request additional data for a systematic review. Part... Read More about Short email with attachment versus long email without attachment when contacting authors to request unpublished data for a systematic review: a nested randomised trial.

Automated segmentation of haematoma and perihaematomal oedema in MRI of acute spontaneous intracerebral haemorrhage (2019)
Journal Article
Pszczolkowski, S., Law, Z. K., Gallagher, R. G., Meng, D., Swienton, D. J., Morgan, P. S., …Dineen, R. A. (2019). Automated segmentation of haematoma and perihaematomal oedema in MRI of acute spontaneous intracerebral haemorrhage. Computers in Biology and Medicine, 106, 126-139. https://doi.org/10.1016/j.compbiomed.2019.01.022

Background Spontaneous intracerebral haemorrhage (SICH) is a common condition with high morbidity and mortality. Segmentation of haematoma and perihaematoma oedema on medical images provides quantitative outcome measures for clinical trials and may... Read More about Automated segmentation of haematoma and perihaematomal oedema in MRI of acute spontaneous intracerebral haemorrhage.

Human tissue kallikrein in the treatment of acute ischemic stroke (2019)
Journal Article
Alexander-Curtis, M., Pauls, R., Chao, J., Volpi, J. J., Appel, S. H., Bath, P. M., & Verdoorn, T. A. (2019). Human tissue kallikrein in the treatment of acute ischemic stroke. Therapeutic Advances in Neurological Disorders, 12, 1-15. https://doi.org/10.1177/1756286418821918

Acute ischemic stroke (AIS) remains a major cause of death and disability throughout the world. The most severe form of stroke results from large vessel occlusion of the major branches of the Circle of Willis. The treatment strategies currently avail... Read More about Human tissue kallikrein in the treatment of acute ischemic stroke.

Effect of glyceryl trinitrate on haemodynamics in acute stroke: data from the Efficacy of Nitric Oxide in Stroke trial (2019)
Journal Article
Appleton, J. P., Woodhouse, L. J., Bereczki, D., Berge, E., Christensen, H. K., Collins, R., …ENOS Investigators. (2019). Effect of glyceryl trinitrate on haemodynamics in acute stroke: data from the Efficacy of Nitric Oxide in Stroke trial. Stroke, 50(2), 405-412. https://doi.org/10.1161/STROKEAHA.118.023190

Background and Purpose: Increased blood pressure (BP), heart rate and their derivatives (variability, pulse pressure, rate-pressure product [RPP]) are associated with poor clinical outcome in acute stroke. We assessed the effects of glyceryl trinitra... Read More about Effect of glyceryl trinitrate on haemodynamics in acute stroke: data from the Efficacy of Nitric Oxide in Stroke trial.

Development of a Non-invasive Device for Swallow Screening in Patients at Risk of Oropharyngeal Dysphagia: Results from a Prospective Exploratory Study (2019)
Journal Article
Steele, C. M., Mukherjee, R., Kortelainen, J. M., Pölönen, H., Jedwab, M., Brady, S. L., …Muehlemann, N. (2019). Development of a Non-invasive Device for Swallow Screening in Patients at Risk of Oropharyngeal Dysphagia: Results from a Prospective Exploratory Study. Dysphagia, 34(5), 698-707. https://doi.org/10.1007/s00455-018-09974-5

Oropharyngeal dysphagia is prevalent in several at-risk populations, including post-stroke patients, patients in intensive care and the elderly. Dysphagia contributes to longer hospital stays and poor outcomes, including pneumonia. Early identificati... Read More about Development of a Non-invasive Device for Swallow Screening in Patients at Risk of Oropharyngeal Dysphagia: Results from a Prospective Exploratory Study.