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| 1 | Blood pressure management in acute stroke显示文摘Blood pressure(BP)is elevated in 75%or more of patients with acute stroke and is associated with poor outcomes.Whether to modulate BP in acute stroke has long been debated.With the loss of normal cerebral autoregulation,theoretical concerns are twofold:high BP can lead to cerebral oedema,haematoma expansion or haemorrhagic transformation;and low BP can lead to increased cerebral infarction or perihaematomal ischaemia.Published evidence from multiple large,high-quality,randomised trials is increasing our understanding of this challenging area,such that BP lowering is recommended in acute intracerebral haemorrhage and is safe in ischaemic stroke.Here we review the evidence for BP modulation in acute stroke,discuss the issues raised and look to on-going and future research to identify patient subgroups who are most likely to benefit. | Jason P Appleton Nikola Sprigg Philip M Bath | 2016 | Stroke & Vascular Neurology2016，1，2： | 7 |
| 2 | It is safe to use transdermal glyceryl trinitrate to lower blood pressure in patients with acute ischaemic stroke with carotid stenosis显示文摘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 stenosis using data from the Efficacy of Nitric Oxide in Stroke(ENOS)Trial.Methods ENOS randomised 4011 patients with acute stroke and raised systolic BP(140-220 mm Hg)to transdermal GTN or no GTN within 48 hours of onset.Those on prestroke antihypertensives were also randomised to stop or continue their medication for 7 days.The primary outcome was the modified Rankin Scale(mRS)at day 90.Ipsilateral carotid stenosis was split:<30%;30-<50%;50-<70%;≥70%.Data are ORs with 95%CIs adjusted for baseline prognostic factors.results 2023(60.5%)ischaemic stroke participants had carotid imaging.As compared with<30%,≥70%ipsilateral stenosis was associated with an unfavourable shift in mRS(worse outcome)at 90 days(OR 1.88,95%CI 1.44 to 2.44,p<0.001).Those with≥70%stenosis who received GTN versus no GTN had a favourable shift in mRS(OR 0.56,95%CI 0.34 to 0.93,p=0.024).In those with 50-<70%stenosis,continuing versus stopping prestroke antihypertensives was associated with worse disability,mood,quality of life and cognition at 90 days.Clinical outcomes did not differ across bilateral stenosis groups.Conclusions Following ischaemic stroke,severe ipsilateral carotid stenosis is associated with worse functional outcome at 90 days.GTN appears safe in ipsilateral or bilateral carotid stenosis,and might improve outcome in severe ipsilateral carotid stenosis. | Jason P Appleton Lisa J Woodhouse Andrew Belcher Daniel Bereczki Eivind Berge Valeria Caso Hui Meng Chang Hanne K Christensen Ronan Collins John Gommans Ann C Laska George Ntaios Serefnur Ozturk Gillian M Sare Szabolcs Szatmari Yongjun Wang Joanna M Wardlaw Nikola Sprigg Philip M Bath for the ENOS investigators | 2019 | Stroke & Vascular Neurology2019，4，1： | 6 |
| 3 | Remote platelet function testing using P-selectin expression in patients with recent cerebral ischaemia on clopidogrel显示文摘Background Antiplatelet agents reduce recurrence after cerebral ischaemia but are not effective in all patients,in part because of treatment resistance.The primary aim was to assess the proportion of patients who are insensitive to clopidogrel.The secondary aim was to assess the association between insensitivity to clopidogrel and recurrent cerebrovascular events.Methods Following written informed consent,independent patients with a recent non-cardioembolic ischaemic stroke or transient ischaemic attack,and taking clopidogrel,were enrolled.Platelet function was assessed with remote measurement of surface expression of P-selectin(CD62P)using commercial kits sensitive to aspirin or clopidogrel.Participants’general practitioners provided details on recurrent vascular events at least 90 days later.Data are mean(SD)and median[IQR].Resistance was defined as:aspirin median fluorescence(MF)>500 units,clopidogrel MF>860 units.Non-parametric descriptors and tests were used.Results 63 patients were recruited:mean age 64(13.7)years,women 47%.At baseline,59(95%)patients were taking clopidogrel alone with 3(5%)on combined clopidogrel and aspirin.Assessment of platelet surface P-selectin revealed:aspirin test 528[317,834],>50054.8%;clopidogrel test 429[303,656],>86011.3%.No participants on aspirin and clopidogrel showed aspirin resistance.Thirteen(20.6%)patients had a recurrent cerebrovascular event;those with an ischaemic stroke had a non-significantly higher baseline P-selectin using the clopidogrel test as compared with those with no recurrence:626[380,801]versus 406[265,609],p=0.08.Conclusions Remote measurement of platelet function assessed using the platelet surface expression of P-selectin is feasible.11%of patients taking clopidogrel showed resistance.No significant associations were noted between clopidogrel resistance and recurrent ischaemic events. | Jason Philip Appleton Carla Richardson Natalia Dovlatova Jane May Nikola Sprigg Stan Heptinstall Philip M Bath | 2021 | Stroke & Vascular Neurology2021，6，1： | 2 |
| 4 | 显示文摘 | APPLETON J M H TYSON J F MOUNCE R P | 1986 | Anal Chim Acta1986，179，： | 1 |
| 5 | The Effect of Strenuous Exercise on mRNA Concentrations of Interleukin-12, Interferon-gamma and Interleukin-4 in Equine Pulmonary and Peripheral Blood Mononuclear Cells 显示文摘 | AINSWORTH D M APPLETON J A EICKER S W | 2003 | Vet Immunol Immunopathol2003，91，1： | 1 |
| 6 | Consensus on Trichinella spiralis antigens and antibody显示文摘 | APPLETON J A BELL R G M HOMAN W | 1991 | Parasitol Today1991，7，2： | 1 |
| 7 | Anhidrotic ectodermal dysplasia associated with specific antibody deficiency显示文摘 | Abinun M Spickett G Appleton AL | 1996 | EurJ Pediatr1996，155，2： | 1 |
| 8 | Mercury contamination associated with artisanal gold mining on the island of Mindanao,the Philippines显示文摘 | APPLETON J D WILLIAMS T M BREWARD N APOSTOL A MIGUEL J MIRANDA C | 1999 | The Science of the Total Environment1999，228，： | 1 |
| 9 | Reducing the pain of childhood vaccination:an evidence-based clinical practice guideline显示文摘 | Taddio A Appleton M Bortolussi R | 2010 | CMAJ2010，，18： | 1 |
| 10 | Designing Magneto--Rheological Dampers in a Fire Out--of-battery Recoil System显示文摘 | Ahmadian M Appleton R J Norris J A | 2003 | IEEE Transactions on Magnetics2003，11，39： | 1 |
| 11 | Anhidrotic ectodermal dysplasia associated with specific antibody deficiency 显示文摘 | Abinun M Spickett G Appleton AL Flood T Cant AJ | 1996 | Eur J Pediatr1996，155，： | 1 |
| 12 | Copper toxicity in housed lambs显示文摘 | Adamson A H Valks D A and M A Appleton | 1969 | Veterinary Research1969，，85： | 1 |
| 13 | Predicting anterior cruciate ligament integrity in patients with osteoarthritis 显示文摘 | Trompeter A J Gill K Appleton M | 2009 | Knee Surgery Sports Traumatology Arthroscopy2009，17，6： | 1 |
| 14 | An Analytical Study of Fire Out of Battery Using Magneto-- rheological Dampers显示文摘 | Ahmadian M Appleton R J Norris J A | 2002 | Shock and Vibration2002，，9： | 1 |
| 15 | The rapid deter- ruination of chemical oxygen demand in waste waters and effluents by flow injection analysis 显示文摘 | Appleton J M H Tyson J F Moouce R P | 1986 | Anal Chim Acta1986，179，： | 1 |
| 16 | Specific Residues in the Connector Loop of the Human Cytomegalovirus DNA Polymerase Accessory Protein UL44 Are Crucial for Interaction with the UL54 Catalytic Subunit显示文摘 | Loregian A Appleton B A Hogle J M | 2004 | Journal of Virology2004，78，17： | 1 |
| 17 | Kottamides A-D: Novel bioactive imidazolone-containing alkaloids from the new zealand ascidian Pycnoclavella kottae显示文摘 | Appleton D R Page M J Lambert G | 2002 | J Org Chem2002，67，15： | 1 |
| 18 | Cross -contamination potential with dental equipment 显示文摘 | Lewis DL Arens M Appleton SS | 1992 | Lancet1992，340，21： | 1 |
| 19 | Contemplating cyc- ling to work: attitudes and perceptions in different stages of change显示文摘 | Gatersleben B Appleton K M | 2007 | Transportation Research Part A2007，41，4： | 1 |
| 20 | The rapid determination of chemical oxygen demand in waste waters and effluents by flow injection analysis 显示文摘 | Appleton J M H Tyson J F and Moouce R P | 1986 | Anal Chim Acta1986，179，： | 1 |
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