Pre-hospital transdermal glyceryl trinitrate in patients with stroke mimics: data from the RIGHT-2 randomised-controlled ambulance trial (2022)
Journal Article
Roffe. (2022). Pre-hospital transdermal glyceryl trinitrate in patients with stroke mimics: data from the RIGHT-2 randomised-controlled ambulance trial. BMC Emergency Medicine, 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.

THE METOCLOPRAMIDE FOR AVOIDING PNEUMONIA AFTER STROKE (MAPS-2) TRIAL: A SINGLE-BLIND RCT OF METOCLOPRAMIDE FOR THE PREVENTION OF PNEUMONIA IN PATIENTS WITH DYSPHAGIA AFTER STROKE (2021)
Presentation / Conference
Roffe, C., Bath, P., Warusevitane, A., Smith, C., Dixit, A., Sprigg, N., …Ogollah, R. (2021, November). THE METOCLOPRAMIDE FOR AVOIDING PNEUMONIA AFTER STROKE (MAPS-2) TRIAL: A SINGLE-BLIND RCT OF METOCLOPRAMIDE FOR THE PREVENTION OF PNEUMONIA IN PATIENTS WITH DYSPHAGIA AFTER STROKE. Presented at UK Stroke Forum 2021, Virtual

Oxygen desaturation and adverse outcomes in acute stroke: secondary analysis of the HeadPoST study (2021)
Journal Article
Roffe. (2021). Oxygen desaturation and adverse outcomes in acute stroke: secondary analysis of the HeadPoST study. Clinical Neurology and Neurosurgery, 106796 - 106796. https://doi.org/10.1016/j.clineuro.2021.106796

Objective: Uncertainty exists over the prognostic significance of low arterial oxygen saturation (SaO(2)) in acute stroke. We aimed to determine the strength of association of SaO(2) and adverse outcomes among participants of the international Head P... Read More about Oxygen desaturation and adverse outcomes in acute stroke: secondary analysis of the HeadPoST study.

Purines for Rapid Identification of Stroke Mimics (PRISM): study protocol for a diagnostic accuracy study (2021)
Journal Article
Roffe. (2021). Purines for Rapid Identification of Stroke Mimics (PRISM): study protocol for a diagnostic accuracy study. Diagnostic and Prognostic Research, https://doi.org/10.1186/s41512-021-00098-3

<jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Rapid treatment of stroke improves outcomes, but accurate early recognition can be challenging. Between 20 and 40% of patients suspected to have stroke by ambulan... Read More about Purines for Rapid Identification of Stroke Mimics (PRISM): study protocol for a diagnostic accuracy study.

The use of hypnotherapy as treatment for functional stroke: A case series from a single center in the UK (2021)
Journal Article
Sanyal, R., Raseta, M., Natarajan, I., & Roffe, C. (2022). The use of hypnotherapy as treatment for functional stroke: A case series from a single center in the UK. International Journal of Stroke, 17(1), 59-66. https://doi.org/10.1177/1747493021995590

Background Functional neurological disorder is defined by symptoms not explained by the current model of disease and its pathophysiology. It is found in 8.4% of patients presenting as acute stroke. Treatment is difficult and recurrence rates are high... Read More about The use of hypnotherapy as treatment for functional stroke: A case series from a single center in the UK.

Assessment of fracture risk tools in care home residents: a multi-centre observational pilot study (2020)
Journal Article
Ihama, F., Pandyan, A., & Roffe, C. (2020). Assessment of fracture risk tools in care home residents: a multi-centre observational pilot study. European Geriatric Medicine, 12, 79-89. https://doi.org/10.1007/s41999-020-00383-2

Background
Fragility fractures are common in care home residents but established tools have not been tested in this population. Aim: To identify the most practicable tool for use.

Methods
Design
Multicentre prospective observational cohort pilo... Read More about Assessment of fracture risk tools in care home residents: a multi-centre observational pilot study.

Impact of COVID-19 on stroke admissions, treatments, and outcomes at a comprehensive stroke centre in the United Kingdom (2020)
Journal Article
Roffe. (2020). Impact of COVID-19 on stroke admissions, treatments, and outcomes at a comprehensive stroke centre in the United Kingdom. Neurological Sciences, https://doi.org/10.1007/s10072-020-04775-x

Introduction The coronavirus disease (COVID-19) pandemic has changed routine clinical practice worldwide with major impacts on the provision of care and treatment for stroke patients.

Methods This retrospective observational study included all pat... Read More about Impact of COVID-19 on stroke admissions, treatments, and outcomes at a comprehensive stroke centre in the United Kingdom.

Mechanical thrombectomy: can it be safely delivered out of hours in the UK? (2020)
Journal Article
Weddell, J., Parr, E., Knight, S., Muddegowda, G., Natarajan, I., Chembala, J., …Roffe, C. (2020). Mechanical thrombectomy: can it be safely delivered out of hours in the UK?. BMC Neurology, 20, Article 326. https://doi.org/10.1186/s12883-020-01909-8

BACKGROUND: Mechanical thrombectomy was approved by NICE as a treatment for stroke in 2016. However, most of the evidence is from studies conducted during working hours. Only few centres in the UK perform thrombectomies out-of-hours. The Royal Stoke... Read More about Mechanical thrombectomy: can it be safely delivered out of hours in the UK?.

Noncontrast Computed Tomography Signs as Predictors of Hematoma Expansion, Clinical Outcome, and Response to Tranexamic Acid in Acute Intracerebral Hemorrhage (2020)
Journal Article
Roffe. (2020). Noncontrast Computed Tomography Signs as Predictors of Hematoma Expansion, Clinical Outcome, and Response to Tranexamic Acid in Acute Intracerebral Hemorrhage. Stroke, 121-128. https://doi.org/10.1161/STROKEAHA.119.026128

Background and Purpose— Blend, black hole, island signs, and hypodensities are reported to predict hematoma expansion in acute intracerebral hemorrhage. We explored the value of these noncontrast computed tomography 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
Roffe. (2019). Prehospital Transdermal Glyceryl Trinitrate for Ultra-Acute Intracerebral Hemorrhage. Stroke, 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 rando... Read More about Prehospital Transdermal Glyceryl Trinitrate for Ultra-Acute Intracerebral Hemorrhage.

Association of Baseline Hyperglycaemia with Outcomes of Diabetic and Non-diabetic Acute Ischaemic Stroke Patients treated with Intravenous Thrombolysis: A Propensity Score Matched Analysis from the SITS-ISTR Registry (2019)
Journal Article
Roffe. (2019). Association of Baseline Hyperglycaemia with Outcomes of Diabetic and Non-diabetic Acute Ischaemic Stroke Patients treated with Intravenous Thrombolysis: A Propensity Score Matched Analysis from the SITS-ISTR Registry. Diabetes, db190440 - db190440. https://doi.org/10.2337/db19-0440

Available data from observational studies on the association of admission hyperglycaemia (aHG) with outcomes of acute ischaemic stroke (AIS) patients treated with intravenous thrombolysis (IVT) are contradictory especially when stratified by diabetes... Read More about Association of Baseline Hyperglycaemia with Outcomes of Diabetic and Non-diabetic Acute Ischaemic Stroke Patients treated with Intravenous Thrombolysis: A Propensity Score Matched Analysis from the SITS-ISTR Registry.

The association between early neurological deterioration and whole blood purine concentration during acute stroke (2019)
Journal Article
Roffe. (2019). The association between early neurological deterioration and whole blood purine concentration during acute stroke. Biomarker Research, https://doi.org/10.1186/s40364-019-0158-y

Background
Early neurological deterioration (END) is common after stroke. Prediction could identify patients requiring additional monitoring and intervention. Purines, breakdown products of adenosine triphosphate which accumulate during acute hypoxi... Read More about The association between early neurological deterioration and whole blood purine concentration during acute stroke.

Point-of-care measurements reveal release of purines into venous blood of stroke patients (2019)
Journal Article
Roffe. (2019). Point-of-care measurements reveal release of purines into venous blood of stroke patients. Purinergic Signalling, 237-246. https://doi.org/10.1007/s11302-019-09647-4

Stroke is a leading cause of death and disability. Here, we examine whether point-of-care measurement of the purines, adenosine, inosine and hypoxanthine, which are downstream metabolites of ATP, has potential to assist the diagnosis of stroke. In a... Read More about Point-of-care measurements reveal release of purines into venous blood of stroke patients.

Route of Feeding as a Proxy for Dysphagia After Stroke and the Effect of Transdermal Glyceryl Trinitrate: Data from the Efficacy of Nitric Oxide in Stroke Randomised Controlled Trial. (2018)
Journal Article
Roffe. (2018). Route of Feeding as a Proxy for Dysphagia After Stroke and the Effect of Transdermal Glyceryl Trinitrate: Data from the Efficacy of Nitric Oxide in Stroke Randomised Controlled Trial. Translational Stroke Research, 120 -129. https://doi.org/10.1007/s12975-017-0548-0

Post-stroke dysphagia is common, associated with poor outcome and often requires non-oral feeding/fluids. The relationship between route of feeding and outcome, as well as treatment with glyceryl trinitrate (GTN), was studied prospectively. The Effic... Read More about Route of Feeding as a Proxy for Dysphagia After Stroke and the Effect of Transdermal Glyceryl Trinitrate: Data from the Efficacy of Nitric Oxide in Stroke Randomised Controlled Trial..

Structured light plethysmography measures asynchronous breathing patterns in patients with acute stroke (Meeting Abstract) (2016)
Journal Article
Gilchrist, & Roffe. (2016). Structured light plethysmography measures asynchronous breathing patterns in patients with acute stroke (Meeting Abstract). European Respiratory Journal, https://doi.org/10.1183/13993003.congress-2016.PA4156

Background
The extent of respiratory compromise following a stroke depends on any pre-existing respiratory illness and the aetiology, location and extent of the lesion. Acquired respiratory infection in subsequent days may alter respiratory function... Read More about Structured light plethysmography measures asynchronous breathing patterns in patients with acute stroke (Meeting Abstract).

Low-Dose versus Standard-Dose Intravenous Alteplase in Acute Ischemic Stroke (2016)
Journal Article
Roffe. (2016). Low-Dose versus Standard-Dose Intravenous Alteplase in Acute Ischemic Stroke. New England Journal of Medicine, 2313-2323. https://doi.org/10.1056/NEJMoa1515510

BACKGROUND
Thrombolytic therapy for acute ischemic stroke with a lower-than-standard dose of intravenous alteplase may improve recovery along with a reduced risk of intracerebral hemorrhage.

METHODS
Using a 2-by-2 quasi-factorial open-label desi... Read More about Low-Dose versus Standard-Dose Intravenous Alteplase in Acute Ischemic Stroke.

The stroke oxygen pilot study: a randomized controlled trial of the effects of routine oxygen supplementation early after acute stroke--effect on key outcomes at six months (2013)
Journal Article
Ali, K., Warusevitane, A., Lally, F., Sim, J., Sills, S., Pountain, S., …Roffe, C. (2013). The stroke oxygen pilot study: a randomized controlled trial of the effects of routine oxygen supplementation early after acute stroke--effect on key outcomes at six months. PloS one, 8(6), Article e59274. https://doi.org/10.1371/journal.pone.0059274

INTRODUCTION: Post-stroke hypoxia is common, and may adversely affect outcome. We have recently shown that oxygen supplementation may improve early neurological recovery. Here, we report the six-month outcomes of this pilot study. METHODS: Patients w... Read More about The stroke oxygen pilot study: a randomized controlled trial of the effects of routine oxygen supplementation early after acute stroke--effect on key outcomes at six months.