P M Bath

..These results indicate long-term beneficial effects of a single dose of G-CSF administered on reperfusion, and illustrate the need to further investigate the mechanisms of G-CSF action...

..Baseline severity and causal subtype are predictors of outcome in ischemic stroke. We used data from the Tinzaparin in Acute Ischemic Stroke Trial (TAIST) to further assess the relationship among stroke subtype, early recovery, and outcome...

..However, the effect of results of clinical trials of devices and non-pharmacological interventions on clinical practice is less clear...

..If these approaches are followed, then the risk of missing useful treatment effects for acute stroke will diminish...

..This systematic review assesses the safety and efficacy of triple antiplatelet therapy in comparison with dual therapy in reducing recurrent vascular events...

..We hypothesised that functional outcome at the end of follow-up, a measure of efficacy, is also a powerful measure of safety and tested this in a systematic review...

..To review completed trials assessing effect of hormone replacement therapy on subsequent risk of stroke, assessing stroke by pathological type, severity, and outcome...

..We assessed the safety of G-CSF in recent stroke in a phase IIb single-center randomized, controlled trial...

..Aims Numbers-needed-to-treat may be calculated for ordinal data from parallel group trials by using an unmatched comparison of all subjects or by generating matched pairs of patients nested within the study...

..Long-term antiplatelet therapy is effective at reducing recurrence after ischemic stroke. However, the relative safety and efficacy of combined aspirin-dipyridamole or clopidogrel are not known in patients with acute ischemic stroke...

..High blood pressure (BP) is common in acute ischemic stroke and associated independently with a poor functional outcome. However, the management of BP acutely remains unclear because no large trials have been completed...

..This first-ever individual animal meta-analysis was used to assess the preclinical studies...

..They have been shown to be neuroprotective in experimental stroke. Some CSFs also mobilise the release of bone marrow stem cells into the circulation...

..Although this is not a novel idea in the statistical community, ordinal outcomes have not been applied to stroke prevention trials in the past...

..Mean platelet volume (MPV) is positively associated with measures of platelet activity and may be a useful indicator of the risk of vascular events in a variety of patient groups...

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..We assessed, in a double-blind randomised controlled trial, whether the nitric oxide (NO) donor glyceryl trinitrate (GTN, a known systemic and cerebral vasodilator), would lower BP and alter platelet function...

..The additional costs involved should be seen as reasonable when compared with the resources that would have been expended in running a clinical trial that subsequently proved negative...

..Low-molecular-weight heparins and heparinoids are superior to unfractionated heparin in the prevention and treatment of venous thromboembolism, but their safety and efficacy in acute ischaemic stroke are inadequately defined...

..The Asp/Dip/AR-C was superior to abciximab and MK-852 in inhibiting platelet and leukocyte function...

..The combination of aspirin and dipyridamole also reduces the composite of nonfatal stroke, nonfatal myocardial infarction, and vascular death as compared with aspirin alone...

..In particular, dipyridamole reduces plasma vWf and clopidogrel lowers plasma PAI-1 levels. These effects may explain, in part, their roles in preventing atherothrombogenesis...

..The occurrence of symptomatic intracranial hemorrhage within 14 days was independent of SBP...

..21%). These data underline the relative variability of this embolic model and provide important preliminary information regarding the value of early changes in T2* in predicting eventual infarct size...

..Since antihypertensive therapy reduces the risk of stroke and myocardial infarction, MKs are a novel therapeutic target for the prevention of vascular events...

..High blood pressure (BP) is present in approximately 80% of patients with acute ischemic stroke and is independently associated with poor outcome. There are few data examining the relationship between admission BP and acute CT findings...

..Aspirin, dipyridamole and clopidogrel are effective in secondary vascular prevention. Combination therapy with three antiplatelet agents might maximise the benefit of antiplatelet treatment in the secondary prevention of ischaemic stroke...

..We used data from the 'Tinzaparin in Acute Ischaemic Stroke Trial' (TAIST) to assess the relationship between stroke severity, early recovery, outcome and OCSP syndrome...

..Agents that modify these measures may improve functional outcome after stroke...

..Moderate lowering of BP might improve outcome. Acute BP lowering needs to be tested in 1 or more large, randomized trials...

..Pro-inflammatory and pro-thrombotic effects of CD40L and tissue factor may be an explanation of the negative clinical effects using GPIIb/IIIa antagonists...

..Although this does not rule out a role for AG as a neuroprotective agent via its ability to inhibit iNOS, these findings indicate that neuroprotective actions of AG may also be mediated via other cellular targets...

..BACKGROUND and..

..We used data from the Tinzaparin in Acute Ischaemic Stroke Trial (TAIST) to assess the relationship between sex and QoL after ischemic stroke...

..These deficiencies will together have resulted in trials being far too small and reduced their chance of being able to detect real treatment effects...

..Although megakaryocyte changes are likely, in part, to be secondary to the stroke, they could also precede the stroke and therefore explain some of the increased platelet function observed in acute stroke...

..Asymptomatic hemorrhagic transformation of infarction (AHTI) is common, but its risk factors and relationship with functional outcome are poorly defined...

..Randomized controlled trials (RCTs) have shown that the risk of stroke and venous thromboembolism (VTE) is increased with hormone replacement therapy (HRT); the effect on coronary heart disease (CHD) remains unclear...

..Trials need to assess the effect of lowering BP on functional outcome...

..High blood pressure (BP) is associated independently with poor outcome after acute ischemic stroke, although in most analyses "baseline" BP was measured 24 hours or more postictus, and not during the hyperacute period...

..There are four large ongoing trials examining whether to continue or stop pre-stroke antihypertensive therapy (COSSACS, ENOS) or lower BP in acute stroke (ENOS, SCAST) or haemorrhage (INTERACT 2)...

..Functional outcome is usually analyzed using a yes or no answer, eg, death or dependency versus independence. We assessed which statistical approaches are most efficient in analyzing outcomes from stroke trials...

..Similarly, the physiological mechanisms which regulate MPV within the megakaryocyte need to be elucidated. Whether MPV ever becomes a routinely requested test remains to be seen but changes in methodology will be required first...

..Motor impairment and death were also reduced. Further studies assessing dose response, administration time, length of ischaemia and long-term functional recovery are needed...

..On the basis of these data, estrogens are a candidate treatment for ischemic stroke, although further preclinical studies are also warranted...

..72), 14.6 mm Hg. Although large falls or increases in BP are associated with a worse outcome, modest reductions may reduce death and combine death or dependency, although the CIs are wide and compatible with an overall benefit or hazard...

..Suboptimal statistical analyses may be failing to detect effective interventions. Adjusting outcomes for baseline prognostic factors in the analysis may improve the efficiency of analysis of outcomes...

..Particular uncertainty exists in patients with carotid stenosis in whom lowering BP might reduce cerebral perfusion and worsen outcome...

..High blood pressure (BP) in acute stroke is associated independently with a poor outcome. Recent evidence suggests that other hemodynamic parameters may also be associated with outcomes following stroke...

..This suggests that part of the neuroprotection may be attributed to the ability of G-CSF to reduce the inflammatory response...

..Thus, progesterone is neuroprotective in both permanent and transient ischemia, and this effect is related to the suppression of specific aspects of the inflammatory response...

..The use of drugs to enhance recovery ("rehabilitation pharmacology") has been assessed. Amphetamine can improve outcome in experimental models of stroke, and several small clinical trials have assessed its use in stroke...

..Using a metaepidemiologic approach, we addressed the effect of randomization, blinding, and use of comorbid animals on the estimate of how effectively therapeutic interventions reduce infarct size...

..Herein we demonstrate the applicability of our models in an independent sample of patients from controlled clinical trials...

..Although the underlying mechanisms are still unclear, our findings are consistent with a complex relationship between height, hypertension, GH1 promoter haplotype, GHR polymorphism and the risk of stroke...

..The rationale for the study is presented and characteristics of patients recruited in Poland and elsewhere compared...

..The Virtual International Stroke Trials Archive aims to aid the planning of clinical trials by collating and providing access to a rich resource of patient data to perform exploratory analyses...

..Although this systematic review provides some supporting evidence for a neuroprotective role of progesterone following either cerebral ischaemia or TBI importantly it highlights areas which need further pre-clinical investigation...