Development and validation of a novel questionnaire to describe and assess sensations and triggers associated with refractory and unexplained chronic cough.

Introduction: Refractory or unexplained chronic cough (RUCC) is a common clinical problem with no effective diagnostic tools. The Sensations and Triggers Provoking Cough questionnaire (TOPIC) was developed to characterise cough in RUCC versus cough in other conditions.

Methods: Content analysis of participant interviews discussing the sensations and triggers of chronic cough informed TOPIC development.

Business Strategy as Human Rights Risk: the Case of Private Equity.

In this article, we apply the UN Guiding Principles on Business and Human Rights to the private equity (PE) business model. PE firms often adopt a controversial, 'value extractive', business model based on high debt and extreme cost-cutting to generate investor returns. PE firms own large numbers of companies, including in many rights-related sectors.

Trainee radiologist reports as a source of confirmation bias in radiology.

Aim: To assess and quantify the relationship between trainee reporting and radiology errors.

Materials And Methods: A retrospective analysis of the 100 most recent cases reviewed by a discrepancy forum in a tertiary neuroradiology service was performed. Data on the time of the scan and the presence of a trainee report were collected, with comparison being made between the cohort of erroneous reports and the overall service.

Novel mutation causes both motor neuronopathy and distal myopathy.

Objective: To identify the cause of isolated distal weakness in a family with both neuropathic and myopathic features on EMG and muscle histology.

Methods: Case study with exome sequencing in 2 affected individuals, bioinformatic prioritization of genetic variants, and segregation analysis of the likely causal mutation. Functional studies included Western blot analysis of the candidate protein before and after heat shock treatment of primary skin fibroblasts.

Radiological appearances in olfactory dysfunction: pictorial review.

Background: Olfactory dysfunction is a common condition that may in some cases require imaging to investigate a potential underlying cause.

Objectives: This review describes the anatomy of normal olfaction and illustrates the pathological substrates of olfactory dysfunction amenable to imaging.

Cysticercosis and epilepsy in rural Tanzania: a community-based case-control and imaging study.

Objective: To assess the contribution of neurocysticercosis (NCC) to the burden of epilepsy in a rural Tanzanian population.

Methods: We identified adult people with epilepsy (PWE) in a door-to-door study in an established demographic surveillance site. PWE and community controls were tested for antibodies to Taenia solium, the causative agent of NCC, and all PWE were offered a computed tomography (CT) head scan.

Spatial ability in radiologists: a necessary prerequisite?

Visuospatial ability is fundamental to the cognitive understanding of the three-dimensional environment and is widely recognized as an important skill in the performance of challenging visuospatial tasks. Its contribution to attainment and performance in a variety of professional disciplines is recognized, but there is relatively little known in relation to its relevance in radiological practice. On the basis of a review of the existing cognitive psychological literature and on the basis of the author's own observations, and on the assumption that spatial ability is of increasing and fundamental importance to high-level performance as a radiologist, it is proposed that consideration should be given to the testing of visuospatial ability as part of the selection process for prospective applicants to radiology training programmes.

EXOSC8 mutations alter mRNA metabolism and cause hypomyelination with spinal muscular atrophy and cerebellar hypoplasia.

The exosome is a multi-protein complex, required for the degradation of AU-rich element (ARE) containing messenger RNAs (mRNAs). EXOSC8 is an essential protein of the exosome core, as its depletion causes a severe growth defect in yeast. Here we show that homozygous missense mutations in EXOSC8 cause progressive and lethal neurological disease in 22 infants from three independent pedigrees.

Clinical reasoning: a 39-year-old man with abdominal cramps.

A 39-year-old lawyer presented with intermittent spasms and pain in his abdominal muscles, particularly the right upper quadrant. These had occurred since his mid-20s and there had been long asymptomatic periods, including 8 years prior to the most recent 4-month exacerbation. Trivial movement triggered a spasm of the abdominal muscles, leading to severe pain, which made breathing uncomfortable and interfered with sleep.

Muscular dystrophy with large mitochondria associated with mutations in the CHKB gene in three British patients: extending the clinical and pathological phenotype.

Three patients with CHKB deficient muscular dystrophy are described which broadens the previously described phenotype. Blood smear in one patient showed Jordans anomaly (vacuolated leukocytes). Gastrointestinal features occurred in two patients and there appeared to be acute deterioration with infection/general anaesthesia.

Disease activity and cognition in rheumatoid arthritis: an open label pilot study.

Introduction: We hypothesised that fatigue in rheumatoid arthritis (RA) is related to TNF-alpha induced dysregulation of cerebral blood flow. Our objectives were to assess fatigue, cognitive function and cerebral blood flow before and after initiation of anti-TNF treatment.

Methods: In a pilot study, 15 patients initiating treatment with adalimumab were assessed for fatigue using a visual analogue scale (FACIT-F), cognitive function using a panel of psychometric tests and regional cerebral blood flow using MR perfusion imaging.

Increased expression of fatty acid binding protein 4 and leptin in resident macrophages characterises atherosclerotic plaque rupture.

Objective: Resident macrophages play an important role in atheromatous plaque rupture. The macrophage gene expression signature associated with plaque rupture is incompletely defined due to the complex cellular heterogeneity in the plaque. We aimed to characterise differential gene expression in resident plaque macrophages from ruptured and stable human atheromatous lesions.

Prevalence of active epilepsy in rural Tanzania: a large community-based survey in an adult population.

Purpose: To estimate the prevalence of active epilepsy in adults in an established demographic surveillance site in rural Tanzania. To describe the clinical characteristics of epilepsy and to estimate the treatment gap in this population.

Methods: A pilot study established that a previously validated screening questionnaire was sensitive for detecting cases of epilepsy in a Kiswahili-speaking Tanzanian population.

Henoch-Schönlein purpura with posterior reversible encephalopathy syndrome.

We describe atypical Henoch-Schönlein purpura with posterior reversible encephalopathy syndrome in a normotensive 11-year-old girl. Her Henoch-Schönlein purpura was atypical because she initially presented with abdominal pain and vomiting and neurologic complications, rather than with the classic rash of Henoch-Schönlein Purpura. This previously healthy child was also unusual because she manifested the radiologic and clinical features of posterior reversible encephalopathy syndrome in the absence of hypertension induced by Henoch-Schönlein purpura.

Primary care access to diagnostics: a paradigm shift.

There is increasing medico-political impetus for the provision of direct access imaging services to primary care. This is likely to have fundamental effects on the way that imaging services are organised and provided, and radiologists need to be aware of the paradigm shift that is being promoted. This commentary summarises some of the key issues arising, and has been written to complement a recent conference organised by the British Institute of Radiology.

MR imaging in Duchenne muscular dystrophy: quantification of T1-weighted signal, contrast uptake, and the effects of exercise.

Purpose: To quantify the differences between normal and corticosteroid-treated Duchenne muscular dystrophy (DMD) lower limb muscle using signal intensity measurements on T(1)-weighted and gadolinium contrast-enhanced images and by measurement of muscle T(2) values, and to investigate the effect of exercise.

Materials And Methods: Eleven ambulant boys with DMD were imaged at 3 Tesla (T(1)-weighted, gadolinium enhancement and T(2) measurement) before stepping exercise and again (gadolinium, T(2) measurement) 4 days later and were compared with five healthy controls imaged 4 days before and after stepping exercise. Muscle region-of-interest signal intensities were referenced to external oil and gadolinium phantoms.

Lower limb radiology of distal myopathy due to the S60F myotilin mutation.

Distal myopathies are a clinically and genetically heterogenous group of disorders in which the distal limb musculature is selectively or disproportionately affected. Precisely defining specific categories is a challenge because of overlapping clinical phenotypes, making it difficult to decide which of the many known causative genes to screen in individual cases. In this study we define the distinguishing magnetic resonance imaging findings in myotilin myopathy by studying 8 genealogically unrelated cases due to the same point mutation in TTID.

Use of high-resolution MRI of the optic nerve in Graves' ophthalmopathy.

The aim of this study was to test the hypothesis that optic neuropathy in Graves' disease is associated with measurable optic nerve compression. Magnetic resonance appearances of 32 normal subjects and 27 patients with Graves' disease were evaluated using T(1) weighted volume imaging with multiplanar reformats along the course of the optic nerve. The optic nerve diameter was measured at seven positions along its course.

Analysis of haemodynamic factors involved in carotid atherosclerosis using computational fluid dynamics.

Atherosclerosis presents a massive healthcare burden in both the developing and developed world. There is mounting evidence relating to the involvement of haemodynamic factors in the pathogenesis of this process. This article aims to review the current understandings that have developed in this area, and to present a demonstrative case study obtained using state of the art computational fluid dynamics (CFD) methodology to model and analyse haemodynamic factors within the atheromatous carotid artery bifurcation.

The disengage deficit in hemispatial neglect is restricted to between-object shifts and is abolished by prism adaptation.

We sought to determine the effects of prism adaptation on peripherally cued visual attention shifting in patients with spatial neglect, using a task devised by Egly et al. (J Exp Psychol Gen 123:161-177, 1994) based on the classic Posner paradigm. This task allowed a comparison of "within-object" versus "between-object" attention shifts.