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Kalidindi S, Gandhi S. Prevalence of Sinus Mucosal Abnormalities on CT of the Head Performed for Headache When Compared With Those Performed for Other Indications. Cureus 2024; 16:e56608. [PMID: 38646207 PMCID: PMC11031627 DOI: 10.7759/cureus.56608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 04/23/2024] Open
Abstract
Background There is a high prevalence of mucosal abnormalities of paranasal sinuses on CT Head scans performed for all indications. The purpose of this study is to see whether or not such abnormalities are more common in scans performed on patients presenting with headaches when compared with those without headaches. Methods Images of CT scans of the brain of 100 consecutive patients from each of the two study groups (a total of 200 scans) were retrospectively reviewed for the presence of sinus mucosal abnormalities and their Lund-Mackay (LM) scores were calculated. A corrected LM score was also calculated using a correction factor for non-visualized sinuses in some scans and osteomeatal complexes in all scans. Radiological reports for these scans were also reviewed to note whether or not they contained any comments on the sinuses. All the reviewed scans were performed between January 1, 2021 and January 22, 2021. Results In the headache group, 17 patients had an LM score above 4 (which was used as the main cut-off point for this study). In the non-headache group, 16 patients had a score greater than 4. The mean LM score in the headache group was 1.24 and in the non-headache group was 1.4. There has been no significant difference in the comparison when corrected LM scores were used. In the headache group, 22 radiology reports contained comments on the sinuses compared to 11 reports in the non-headache group. Conclusion Results of this study indicate that there is no significant difference in the prevalence of clinically important sinus mucosal abnormalities in patients who had a brain CT for headache when compared with other indications. It was found that radiologists tend to comment on the sinuses more often when the indication was headache. It may be reasonable for radiologists to consider reviewing this practice. This might reduce unnecessary referrals to ENT and, more importantly, avoid missing other reasons for headaches.
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Affiliation(s)
| | - Sanjay Gandhi
- Radiology, North Bristol Hospitals NHS Trust, Bristol, GBR
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Kalidindi S, Gandhi S. Workforce Crisis in Radiology in the UK and the Strategies to Deal With It: Is Artificial Intelligence the Saviour? Cureus 2023; 15:e43866. [PMID: 37608900 PMCID: PMC10441819 DOI: 10.7759/cureus.43866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2023] [Indexed: 08/24/2023] Open
Abstract
Radiology has seen rapid growth over the last few decades. Technological advances in equipment and computing have resulted in an explosion of new modalities and applications. However, this rapid expansion of capability and capacity has not been matched by a parallel growth in the number of radiologists. This has resulted in global shortages in the workforce, with the UK being one of the most affected countries. The UK National Health Service has been employing several conventional strategies to deal with the workforce situation with mixed success. The emergence of artificial intelligence (AI) tools that have the potential to increase efficiency and efficacy at various stages in radiology has made it possible for radiology departments to use new strategies and workflows that can offset workforce shortages to some extent. This review article discusses the current and projected radiology workforce situation in the UK and the various strategies to deal with it, including applications of AI in radiology. We highlight the benefits of AI tools in improving efficiency and patient safety. AI has a role along the patient's entire journey from the clinician requesting the appropriate radiological investigation, safe image acquisition, alerting the radiologists and clinicians about critical and life-threatening situations, cancer screening follow up, to generating meaningful radiology reports more efficiently. It has great potential in easing the workforce crisis and needs rapid adoption by radiology departments.
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Devine OP, Harborne AC, Horsfall HL, Joseph T, Marshall-Andon T, Samuels R, Kearsley JW, Abbas N, Baig H, Beecham J, Benons N, Caird C, Clark R, Cope T, Coultas J, Debenham L, Douglas S, Eldridge J, Hughes-Gooding T, Jakubowska A, Jones O, Lancaster E, MacMillan C, McAllister R, Merzougui W, Phillips B, Phillips S, Risk O, Sage A, Sooltangos A, Spencer R, Tajbakhsh R, Adesalu O, Aganin I, Ahmed A, Aiken K, Akeredolu AS, Alam I, Ali A, Anderson R, Ang JJ, Anis FS, Aojula S, Arthur C, Ashby A, Ashraf A, Aspinall E, Awad M, Yahaya AMA, Badhrinarayanan S, Bandyopadhyay S, Barnes S, Bassey-Duke D, Boreham C, Braine R, Brandreth J, Carrington Z, Cashin Z, Chatterjee S, Chawla M, Chean CS, Clements C, Clough R, Coulthurst J, Curry L, Daniels VC, Davies S, Davis R, De Waal H, Desai N, Douglas H, Druce J, Ejamike LN, Esere M, Eyre A, Fazmin IT, Fitzgerald-Smith S, Ford V, Freeston S, Garnett K, General W, Gilbert H, Gowie Z, Grafton-Clarke C, Gudka K, Gumber L, Gupta R, Harlow C, Harrington A, Heaney A, Ho WHS, Holloway L, Hood C, Houghton E, Houshangi S, Howard E, Human B, Hunter H, Hussain I, Hussain S, Jackson-Taylor RT, Jacob-Ramsdale B, Janjuha R, Jawad S, Jelani M, Johnston D, Jones M, Kalidindi S, Kalsi S, Kalyanasundaram A, Kane A, Kaur S, Al-Othman OK, Khan Q, Khullar S, Kirkland P, Lawrence-Smith H, Leeson C, Lenaerts JER, Long K, Lubbock S, Burrell JMD, Maguire R, Mahendran P, Majeed S, Malhotra PS, Mandagere V, Mantelakis A, McGovern S, Mosuro A, Moxley A, Mustoe S, Myers S, Nadeem K, Nasseri R, Newman T, Nzewi R, Ogborne R, Omatseye J, Paddock S, Parkin J, Patel M, Pawar S, Pearce S, Penrice S, Purdy J, Ramjan R, Randhawa R, Rasul U, Raymond-Taggert E, Razey R, Razzaghi C, Reel E, Revell EJ, Rigbye J, Rotimi O, Said A, Sanders E, Sangal P, Grandal NS, Shah A, Shah RA, Shotton O, Sims D, Smart K, Smith MA, Smith N, Sopian AS, South M, Speller J, Syer TJ, Ta NH, Tadross D, Thompson B, Trevett J, Tyler M, Ullah R, Utukuri M, Vadera S, Van Den Tooren H, Venturini S, Vijayakumar A, Vine M, Wellbelove Z, Wittner L, Yong GHK, Ziyada F, McManus IC. The Analysis of Teaching of Medical Schools (AToMS) survey: an analysis of 47,258 timetabled teaching events in 25 UK medical schools relating to timing, duration, teaching formats, teaching content, and problem-based learning. BMC Med 2020; 18:126. [PMID: 32404194 PMCID: PMC7222546 DOI: 10.1186/s12916-020-01571-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 03/24/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND What subjects UK medical schools teach, what ways they teach subjects, and how much they teach those subjects is unclear. Whether teaching differences matter is a separate, important question. This study provides a detailed picture of timetabled undergraduate teaching activity at 25 UK medical schools, particularly in relation to problem-based learning (PBL). METHOD The Analysis of Teaching of Medical Schools (AToMS) survey used detailed timetables provided by 25 schools with standard 5-year courses. Timetabled teaching events were coded in terms of course year, duration, teaching format, and teaching content. Ten schools used PBL. Teaching times from timetables were validated against two other studies that had assessed GP teaching and lecture, seminar, and tutorial times. RESULTS A total of 47,258 timetabled teaching events in the academic year 2014/2015 were analysed, including SSCs (student-selected components) and elective studies. A typical UK medical student receives 3960 timetabled hours of teaching during their 5-year course. There was a clear difference between the initial 2 years which mostly contained basic medical science content and the later 3 years which mostly consisted of clinical teaching, although some clinical teaching occurs in the first 2 years. Medical schools differed in duration, format, and content of teaching. Two main factors underlay most of the variation between schools, Traditional vs PBL teaching and Structured vs Unstructured teaching. A curriculum map comparing medical schools was constructed using those factors. PBL schools differed on a number of measures, having more PBL teaching time, fewer lectures, more GP teaching, less surgery, less formal teaching of basic science, and more sessions with unspecified content. DISCUSSION UK medical schools differ in both format and content of teaching. PBL and non-PBL schools clearly differ, albeit with substantial variation within groups, and overlap in the middle. The important question of whether differences in teaching matter in terms of outcomes is analysed in a companion study (MedDifs) which examines how teaching differences relate to university infrastructure, entry requirements, student perceptions, and outcomes in Foundation Programme and postgraduate training.
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Affiliation(s)
| | | | | | - Tobin Joseph
- UCL Medical School, 74 Huntley Street, London, WC1E 6BT UK
| | - Tess Marshall-Andon
- School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Rd, Cambridge, CB2 0SP UK
| | - Ryan Samuels
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | | | - Nadine Abbas
- Faculty of Medicine, University of Southampton, Building 85, Life Sciences Building, Highfield Campus, Southampton, SO17 1BJ UK
| | - Hassan Baig
- University of Aberdeen, Suttie Centre, Foresterhill, Aberdeen, AB25 2ZD UK
| | - Joseph Beecham
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ UK
| | - Natasha Benons
- Faculty of Health Sciences, University of Bristol Medical School, First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH UK
| | - Charlie Caird
- Imperial College School of Medicine, South Kensington Campus, London, SW7 2AZ UK
| | - Ryan Clark
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, G12 8QQ UK
| | - Thomas Cope
- John Hughlings Jackson Building, University of York, Heslington, York, YO10 5DD UK
| | - James Coultas
- School of Medicine, Keele University, David Weatherall Building, Keele University Campus, Staffordshire, ST5 5BG UK
| | - Luke Debenham
- Birmingham Medical School, Vincent Drive, Edgbaston, Birmingham, West Midlands B15 2TT UK
| | - Sarah Douglas
- University of Edinburgh Medical School, 47 Little France Cres, Edinburgh, EH16 4TJ UK
| | - Jack Eldridge
- Brighton and Sussex Medical School, BSMS Teaching Building, University of Sussex, Brighton, BN1 9PX UK
| | - Thomas Hughes-Gooding
- The Medical School, The University of Sheffield, Beech Hill Road, Sheffield, S10 2RX UK
| | - Agnieszka Jakubowska
- Barts and The London Medical School, 4 Newark St, Whitechapel, London, E1 2AT UK
| | - Oliver Jones
- Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ UK
| | - Eve Lancaster
- Birmingham Medical School, Vincent Drive, Edgbaston, Birmingham, West Midlands B15 2TT UK
| | - Calum MacMillan
- University of Dundee School of Medicine, 4 Kirsty Semple Way, Dundee, DD2 4BF UK
| | - Ross McAllister
- The University of Nottingham, Queen’s Medical Centre, Nottingham, NG7 2UH UK
| | - Wassim Merzougui
- Faculty of Medicine, University of Southampton, Building 85, Life Sciences Building, Highfield Campus, Southampton, SO17 1BJ UK
| | - Ben Phillips
- Whiston Hospital, Warrington Road, Prescot, L35 5DR UK
| | - Simon Phillips
- Medical Sciences Divisional Office, University of Oxford, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU UK
| | - Omar Risk
- Guy’s, King’s and St Thomas’ School of Medical Education, Henriette Raphael Building, Guy’s Campus, London, SE1 1UL UK
| | - Adam Sage
- Queen’s University Belfast, University Road, Belfast, BT7 1NN UK
| | - Aisha Sooltangos
- Manchester Medical School, Stopford Building, Oxford Rd, Manchester, M13 9PT UK
| | - Robert Spencer
- Cardiff University School of Medicine, Cochrane Building, Heath Park Way, Cardiff, CF14 4YU UK
| | - Roxanne Tajbakhsh
- School of Medicine, Worsley Building, University of Leeds, Leeds, LS2 9NL UK
| | - Oluseyi Adesalu
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | - Ivan Aganin
- Brighton and Sussex Medical School, BSMS Teaching Building, University of Sussex, Brighton, BN1 9PX UK
| | - Ammar Ahmed
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE UK
| | - Katherine Aiken
- Queen’s University Belfast, University Road, Belfast, BT7 1NN UK
| | | | - Ibrahim Alam
- University of Aberdeen, Suttie Centre, Foresterhill, Aberdeen, AB25 2ZD UK
| | - Aamna Ali
- School of Medicine, Worsley Building, University of Leeds, Leeds, LS2 9NL UK
| | - Richard Anderson
- School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Rd, Cambridge, CB2 0SP UK
| | - Jia Jun Ang
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | - Fady Sameh Anis
- The University of Nottingham, Queen’s Medical Centre, Nottingham, NG7 2UH UK
| | - Sonam Aojula
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | - Catherine Arthur
- Brighton and Sussex Medical School, BSMS Teaching Building, University of Sussex, Brighton, BN1 9PX UK
| | - Alena Ashby
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE UK
| | - Ahmed Ashraf
- University of Aberdeen, Suttie Centre, Foresterhill, Aberdeen, AB25 2ZD UK
| | - Emma Aspinall
- Whiston Hospital, Warrington Road, Prescot, L35 5DR UK
| | - Mark Awad
- Faculty of Health Sciences, University of Bristol Medical School, First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH UK
| | | | - Shreya Badhrinarayanan
- Brighton and Sussex Medical School, BSMS Teaching Building, University of Sussex, Brighton, BN1 9PX UK
| | - Soham Bandyopadhyay
- Medical Sciences Divisional Office, University of Oxford, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU UK
| | - Sam Barnes
- George Davies Centre, University of Leicester School of Medicine, Lancaster Road, Leicester, LE1 7HA UK
| | - Daisy Bassey-Duke
- Faculty of Health Sciences, University of Bristol Medical School, First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH UK
| | - Charlotte Boreham
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | - Rebecca Braine
- Medical Sciences Divisional Office, University of Oxford, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU UK
| | - Joseph Brandreth
- The University of Nottingham, Queen’s Medical Centre, Nottingham, NG7 2UH UK
| | - Zoe Carrington
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE UK
| | - Zoe Cashin
- Brighton and Sussex Medical School, BSMS Teaching Building, University of Sussex, Brighton, BN1 9PX UK
| | - Shaunak Chatterjee
- Birmingham Medical School, Vincent Drive, Edgbaston, Birmingham, West Midlands B15 2TT UK
| | - Mehar Chawla
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ UK
| | - Chung Shen Chean
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE UK
| | - Chris Clements
- St James’s University Hospital, Beckett Street, Leeds, West Yorkshire LS9 7TF UK
| | - Richard Clough
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | - Jessica Coulthurst
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE UK
| | - Liam Curry
- George Davies Centre, University of Leicester School of Medicine, Lancaster Road, Leicester, LE1 7HA UK
| | - Vinnie Christine Daniels
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | - Simon Davies
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | - Rebecca Davis
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE UK
| | - Hanelie De Waal
- Brighton and Sussex Medical School, BSMS Teaching Building, University of Sussex, Brighton, BN1 9PX UK
| | - Nasreen Desai
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE UK
| | - Hannah Douglas
- University of Edinburgh Medical School, 47 Little France Cres, Edinburgh, EH16 4TJ UK
| | - James Druce
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | | | - Meron Esere
- Medical Sciences Divisional Office, University of Oxford, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU UK
| | - Alex Eyre
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | - Ibrahim Talal Fazmin
- School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Rd, Cambridge, CB2 0SP UK
| | - Sophia Fitzgerald-Smith
- Faculty of Health Sciences, University of Bristol Medical School, First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH UK
| | - Verity Ford
- Faculty of Medicine, University of Southampton, Building 85, Life Sciences Building, Highfield Campus, Southampton, SO17 1BJ UK
| | - Sarah Freeston
- Homerton University Hospital, Homerton Row, London, E9 6SR UK
| | | | - Whitney General
- Faculty of Health Sciences, University of Bristol Medical School, First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH UK
| | - Helen Gilbert
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | - Zein Gowie
- Faculty of Medicine, University of Southampton, Building 85, Life Sciences Building, Highfield Campus, Southampton, SO17 1BJ UK
| | - Ciaran Grafton-Clarke
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE UK
| | - Keshni Gudka
- The University of Nottingham, Queen’s Medical Centre, Nottingham, NG7 2UH UK
| | - Leher Gumber
- Brighton and Sussex Medical School, BSMS Teaching Building, University of Sussex, Brighton, BN1 9PX UK
| | - Rishi Gupta
- UCL Medical School, 74 Huntley Street, London, WC1E 6BT UK
| | - Chris Harlow
- St George’s, University of London, Cranmer Terrace, London, SW17 0RE UK
| | - Amy Harrington
- Faculty of Medicine, University of Southampton, Building 85, Life Sciences Building, Highfield Campus, Southampton, SO17 1BJ UK
| | - Adele Heaney
- Queen’s University Belfast, University Road, Belfast, BT7 1NN UK
| | - Wing Hang Serene Ho
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE UK
| | - Lucy Holloway
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | - Christina Hood
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | - Eleanor Houghton
- The University of Nottingham, Queen’s Medical Centre, Nottingham, NG7 2UH UK
| | - Saba Houshangi
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ UK
| | - Emma Howard
- School of Medicine, Keele University, David Weatherall Building, Keele University Campus, Staffordshire, ST5 5BG UK
| | - Benjamin Human
- School of Medicine, Worsley Building, University of Leeds, Leeds, LS2 9NL UK
| | - Harriet Hunter
- School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Rd, Cambridge, CB2 0SP UK
| | - Ifrah Hussain
- Imperial College School of Medicine, South Kensington Campus, London, SW7 2AZ UK
| | - Sami Hussain
- UCL Medical School, 74 Huntley Street, London, WC1E 6BT UK
| | | | | | - Ryan Janjuha
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ UK
| | - Saleh Jawad
- Faculty of Medicine, University of Southampton, Building 85, Life Sciences Building, Highfield Campus, Southampton, SO17 1BJ UK
| | - Muzzamil Jelani
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | - David Johnston
- School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Rd, Cambridge, CB2 0SP UK
| | - Mike Jones
- University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, LE1 5WW UK
| | - Sadhana Kalidindi
- Faculty of Health Sciences, University of Bristol Medical School, First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH UK
| | - Savraj Kalsi
- John Hughlings Jackson Building, University of York, Heslington, York, YO10 5DD UK
| | - Asanish Kalyanasundaram
- School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Rd, Cambridge, CB2 0SP UK
| | - Anna Kane
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | - Sahaj Kaur
- School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Rd, Cambridge, CB2 0SP UK
| | | | - Qaisar Khan
- University of Aberdeen, Suttie Centre, Foresterhill, Aberdeen, AB25 2ZD UK
| | - Sajan Khullar
- School of Medicine, Keele University, David Weatherall Building, Keele University Campus, Staffordshire, ST5 5BG UK
| | - Priscilla Kirkland
- University of Edinburgh Medical School, 47 Little France Cres, Edinburgh, EH16 4TJ UK
| | - Hannah Lawrence-Smith
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE UK
| | - Charlotte Leeson
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ UK
| | | | - Kerry Long
- Nottingham University Hospitals NHS Trust, Hucknall Rd, Nottingham, NG5 1PB UK
| | - Simon Lubbock
- The University of Nottingham, Queen’s Medical Centre, Nottingham, NG7 2UH UK
| | | | - Rachel Maguire
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | - Praveen Mahendran
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE UK
| | - Saad Majeed
- University of Aberdeen, Suttie Centre, Foresterhill, Aberdeen, AB25 2ZD UK
| | | | - Vinay Mandagere
- Faculty of Health Sciences, University of Bristol Medical School, First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH UK
| | | | - Sophie McGovern
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | - Anjola Mosuro
- Faculty of Health Sciences, University of Bristol Medical School, First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH UK
| | - Adam Moxley
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | - Sophie Mustoe
- Guy’s, King’s and St Thomas’ School of Medical Education, Henriette Raphael Building, Guy’s Campus, London, SE1 1UL UK
| | - Sam Myers
- UCL Medical School, 74 Huntley Street, London, WC1E 6BT UK
| | - Kiran Nadeem
- Manchester Medical School, Stopford Building, Oxford Rd, Manchester, M13 9PT UK
| | - Reza Nasseri
- Faculty of Health Sciences, University of Bristol Medical School, First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH UK
| | - Tom Newman
- School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Rd, Cambridge, CB2 0SP UK
| | - Richard Nzewi
- George Davies Centre, University of Leicester School of Medicine, Lancaster Road, Leicester, LE1 7HA UK
| | - Rosalie Ogborne
- St George’s, University of London, Cranmer Terrace, London, SW17 0RE UK
| | - Joyce Omatseye
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE UK
| | - Sophie Paddock
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ UK
| | - James Parkin
- St George’s, University of London, Cranmer Terrace, London, SW17 0RE UK
| | - Mohit Patel
- John Hughlings Jackson Building, University of York, Heslington, York, YO10 5DD UK
| | - Sohini Pawar
- School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Rd, Cambridge, CB2 0SP UK
| | - Stuart Pearce
- St George’s, University of London, Cranmer Terrace, London, SW17 0RE UK
| | - Samuel Penrice
- University of Dundee School of Medicine, 4 Kirsty Semple Way, Dundee, DD2 4BF UK
| | - Julian Purdy
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | - Raisa Ramjan
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ UK
| | - Ratan Randhawa
- UCL Medical School, 74 Huntley Street, London, WC1E 6BT UK
| | - Usman Rasul
- University of Aberdeen, Suttie Centre, Foresterhill, Aberdeen, AB25 2ZD UK
| | - Elliot Raymond-Taggert
- Faculty of Health Sciences, University of Bristol Medical School, First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH UK
| | - Rebecca Razey
- Imperial College School of Medicine, South Kensington Campus, London, SW7 2AZ UK
| | - Carmel Razzaghi
- Queen’s University Belfast, University Road, Belfast, BT7 1NN UK
| | - Eimear Reel
- Queen’s University Belfast, University Road, Belfast, BT7 1NN UK
| | - Elliot John Revell
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | - Joanna Rigbye
- University of Edinburgh Medical School, 47 Little France Cres, Edinburgh, EH16 4TJ UK
| | | | - Abdelrahman Said
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ UK
| | - Emma Sanders
- Faculty of Health Sciences, University of Bristol Medical School, First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH UK
| | - Pranoy Sangal
- University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, LE1 5WW UK
| | - Nora Sangvik Grandal
- John Hughlings Jackson Building, University of York, Heslington, York, YO10 5DD UK
| | - Aadam Shah
- University of Aberdeen, Suttie Centre, Foresterhill, Aberdeen, AB25 2ZD UK
| | - Rahul Atul Shah
- School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Rd, Cambridge, CB2 0SP UK
| | - Oliver Shotton
- Medical Sciences Divisional Office, University of Oxford, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU UK
| | - Daniel Sims
- Brighton and Sussex Medical School, BSMS Teaching Building, University of Sussex, Brighton, BN1 9PX UK
| | - Katie Smart
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ UK
| | - Martha Amy Smith
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | - Nick Smith
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ UK
| | - Aninditya Salma Sopian
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | - Matthew South
- The University of Nottingham, Queen’s Medical Centre, Nottingham, NG7 2UH UK
| | - Jessica Speller
- George Davies Centre, University of Leicester School of Medicine, Lancaster Road, Leicester, LE1 7HA UK
| | - Tom J. Syer
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ UK
| | - Ngan Hong Ta
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ UK
| | - Daniel Tadross
- School of Medicine, Worsley Building, University of Leeds, Leeds, LS2 9NL UK
| | - Benjamin Thompson
- John Hughlings Jackson Building, University of York, Heslington, York, YO10 5DD UK
| | - Jess Trevett
- John Hughlings Jackson Building, University of York, Heslington, York, YO10 5DD UK
| | - Matthew Tyler
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | - Roshan Ullah
- Birmingham Medical School, Vincent Drive, Edgbaston, Birmingham, West Midlands B15 2TT UK
| | - Mrudula Utukuri
- School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital, Hills Rd, Cambridge, CB2 0SP UK
| | - Shree Vadera
- UCL Medical School, 74 Huntley Street, London, WC1E 6BT UK
| | | | - Sara Venturini
- Aberdeen Royal Infirmary, Foresterhill, Aberdeen, AB25 2ZN UK
| | - Aradhya Vijayakumar
- George Davies Centre, University of Leicester School of Medicine, Lancaster Road, Leicester, LE1 7HA UK
| | - Melanie Vine
- George Davies Centre, University of Leicester School of Medicine, Lancaster Road, Leicester, LE1 7HA UK
| | - Zoe Wellbelove
- John Hughlings Jackson Building, University of York, Heslington, York, YO10 5DD UK
| | - Liora Wittner
- UCL Medical School, 74 Huntley Street, London, WC1E 6BT UK
| | - Geoffrey Hong Kiat Yong
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH UK
| | - Farris Ziyada
- Guy’s, King’s and St Thomas’ School of Medical Education, Henriette Raphael Building, Guy’s Campus, London, SE1 1UL UK
| | - I. C. McManus
- Research Department of Medical Education, UCL Medical School, Gower Street, London, WC1E 6BT UK
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McManus IC, Harborne AC, Horsfall HL, Joseph T, Smith DT, Marshall-Andon T, Samuels R, Kearsley JW, Abbas N, Baig H, Beecham J, Benons N, Caird C, Clark R, Cope T, Coultas J, Debenham L, Douglas S, Eldridge J, Hughes-Gooding T, Jakubowska A, Jones O, Lancaster E, MacMillan C, McAllister R, Merzougui W, Phillips B, Phillips S, Risk O, Sage A, Sooltangos A, Spencer R, Tajbakhsh R, Adesalu O, Aganin I, Ahmed A, Aiken K, Akeredolu AS, Alam I, Ali A, Anderson R, Ang JJ, Anis FS, Aojula S, Arthur C, Ashby A, Ashraf A, Aspinall E, Awad M, Yahaya AMA, Badhrinarayanan S, Bandyopadhyay S, Barnes S, Bassey-Duke D, Boreham C, Braine R, Brandreth J, Carrington Z, Cashin Z, Chatterjee S, Chawla M, Chean CS, Clements C, Clough R, Coulthurst J, Curry L, Daniels VC, Davies S, Davis R, De Waal H, Desai N, Douglas H, Druce J, Ejamike LN, Esere M, Eyre A, Fazmin IT, Fitzgerald-Smith S, Ford V, Freeston S, Garnett K, General W, Gilbert H, Gowie Z, Grafton-Clarke C, Gudka K, Gumber L, Gupta R, Harlow C, Harrington A, Heaney A, Ho WHS, Holloway L, Hood C, Houghton E, Houshangi S, Howard E, Human B, Hunter H, Hussain I, Hussain S, Jackson-Taylor RT, Jacob-Ramsdale B, Janjuha R, Jawad S, Jelani M, Johnston D, Jones M, Kalidindi S, Kalsi S, Kalyanasundaram A, Kane A, Kaur S, Al-Othman OK, Khan Q, Khullar S, Kirkland P, Lawrence-Smith H, Leeson C, Lenaerts JER, Long K, Lubbock S, Burrell JMD, Maguire R, Mahendran P, Majeed S, Malhotra PS, Mandagere V, Mantelakis A, McGovern S, Mosuro A, Moxley A, Mustoe S, Myers S, Nadeem K, Nasseri R, Newman T, Nzewi R, Ogborne R, Omatseye J, Paddock S, Parkin J, Patel M, Pawar S, Pearce S, Penrice S, Purdy J, Ramjan R, Randhawa R, Rasul U, Raymond-Taggert E, Razey R, Razzaghi C, Reel E, Revell EJ, Rigbye J, Rotimi O, Said A, Sanders E, Sangal P, Grandal NS, Shah A, Shah RA, Shotton O, Sims D, Smart K, Smith MA, Smith N, Sopian AS, South M, Speller J, Syer TJ, Ta NH, Tadross D, Thompson B, Trevett J, Tyler M, Ullah R, Utukuri M, Vadera S, Van Den Tooren H, Venturini S, Vijayakumar A, Vine M, Wellbelove Z, Wittner L, Yong GHK, Ziyada F, Devine OP. Exploring UK medical school differences: the MedDifs study of selection, teaching, student and F1 perceptions, postgraduate outcomes and fitness to practise. BMC Med 2020; 18:136. [PMID: 32404148 PMCID: PMC7222458 DOI: 10.1186/s12916-020-01572-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 03/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Medical schools differ, particularly in their teaching, but it is unclear whether such differences matter, although influential claims are often made. The Medical School Differences (MedDifs) study brings together a wide range of measures of UK medical schools, including postgraduate performance, fitness to practise issues, specialty choice, preparedness, satisfaction, teaching styles, entry criteria and institutional factors. METHOD Aggregated data were collected for 50 measures across 29 UK medical schools. Data include institutional history (e.g. rate of production of hospital and GP specialists in the past), curricular influences (e.g. PBL schools, spend per student, staff-student ratio), selection measures (e.g. entry grades), teaching and assessment (e.g. traditional vs PBL, specialty teaching, self-regulated learning), student satisfaction, Foundation selection scores, Foundation satisfaction, postgraduate examination performance and fitness to practise (postgraduate progression, GMC sanctions). Six specialties (General Practice, Psychiatry, Anaesthetics, Obstetrics and Gynaecology, Internal Medicine, Surgery) were examined in more detail. RESULTS Medical school differences are stable across time (median alpha = 0.835). The 50 measures were highly correlated, 395 (32.2%) of 1225 correlations being significant with p < 0.05, and 201 (16.4%) reached a Tukey-adjusted criterion of p < 0.0025. Problem-based learning (PBL) schools differ on many measures, including lower performance on postgraduate assessments. While these are in part explained by lower entry grades, a surprising finding is that schools such as PBL schools which reported greater student satisfaction with feedback also showed lower performance at postgraduate examinations. More medical school teaching of psychiatry, surgery and anaesthetics did not result in more specialist trainees. Schools that taught more general practice did have more graduates entering GP training, but those graduates performed less well in MRCGP examinations, the negative correlation resulting from numbers of GP trainees and exam outcomes being affected both by non-traditional teaching and by greater historical production of GPs. Postgraduate exam outcomes were also higher in schools with more self-regulated learning, but lower in larger medical schools. A path model for 29 measures found a complex causal nexus, most measures causing or being caused by other measures. Postgraduate exam performance was influenced by earlier attainment, at entry to Foundation and entry to medical school (the so-called academic backbone), and by self-regulated learning. Foundation measures of satisfaction, including preparedness, had no subsequent influence on outcomes. Fitness to practise issues were more frequent in schools producing more male graduates and more GPs. CONCLUSIONS Medical schools differ in large numbers of ways that are causally interconnected. Differences between schools in postgraduate examination performance, training problems and GMC sanctions have important implications for the quality of patient care and patient safety.
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Affiliation(s)
- I C McManus
- Research Department of Medical Education, UCL Medical School, Gower Street, London, WC1E 6BT, UK.
| | | | | | - Tobin Joseph
- UCL Medical School, 74 Huntley Street, London, WC1E 6BT, UK
| | - Daniel T Smith
- General Medical Council, Regent's Place, 350 Euston Road, London, NW1 3JN, UK
| | - Tess Marshall-Andon
- School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 0SP, UK
| | - Ryan Samuels
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | | | - Nadine Abbas
- Faculty of Medicine, University of Southampton, Building 85, Life Sciences Building, Highfield Campus, Southampton, SO17 1BJ, UK
| | - Hassan Baig
- University of Aberdeen, Suttie Centre, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Joseph Beecham
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK
| | - Natasha Benons
- Faculty of Health Sciences, University of Bristol Medical School, First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH, UK
| | - Charlie Caird
- Imperial College School of Medicine, South Kensington Campus, London, SW7 2AZ, UK
| | - Ryan Clark
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Thomas Cope
- University of York, John Hughlings Jackson Building, Heslington, York, YO10 5DD, UK
| | - James Coultas
- School of Medicine, Keele University, David Weatherall Building, Keele University Campus, Staffordshire, ST5 5BG, UK
| | - Luke Debenham
- Birmingham Medical School, Vincent Drive, Edgbaston B15 2TT, Birmingham, West Midlands, UK
| | - Sarah Douglas
- University of Edinburgh Medical School, 47 Little France Cres, Edinburgh, EH16 4TJ, UK
| | - Jack Eldridge
- Brighton and Sussex Medical School, BSMS Teaching Building, University of Sussex, Brighton, BN1 9PX, UK
| | - Thomas Hughes-Gooding
- The Medical School, The University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, UK
| | - Agnieszka Jakubowska
- Barts and The London Medical School, 4 Newark St, Whitechapel, London, E1 2AT, UK
| | - Oliver Jones
- Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
| | - Eve Lancaster
- Birmingham Medical School, Vincent Drive, Edgbaston B15 2TT, Birmingham, West Midlands, UK
| | - Calum MacMillan
- University of Dundee School of Medicine, 4 Kirsty Semple Way, Dundee, DD2 4BF, UK
| | - Ross McAllister
- The University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Wassim Merzougui
- Faculty of Medicine, University of Southampton, Building 85, Life Sciences Building, Highfield Campus, Southampton, SO17 1BJ, UK
| | - Ben Phillips
- Whiston Hospital, Warrington Road, Prescot, L35 5DR, UK
| | - Simon Phillips
- Medical Sciences Divisional Office, University of Oxford, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| | - Omar Risk
- Guy's, King's and St Thomas' School of Medical Education, Henriette Raphael Building, Guy's Campus, London, SE1 1UL, UK
| | - Adam Sage
- Queen's University Belfast, University Road, Belfast, BT7 1NN, UK
| | - Aisha Sooltangos
- Manchester Medical School, Stopford Building, Oxford Rd, Manchester, M13 9PT, UK
| | - Robert Spencer
- Cardiff University School of Medicine, Cochrane Building, Heath Park Way, Cardiff, CF14 4YU, UK
| | - Roxanne Tajbakhsh
- School of Medicine, University of Leeds, Worsley Building, Leeds, LS2 9NL, UK
| | - Oluseyi Adesalu
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Ivan Aganin
- Brighton and Sussex Medical School, BSMS Teaching Building, University of Sussex, Brighton, BN1 9PX, UK
| | - Ammar Ahmed
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE, UK
| | - Katherine Aiken
- Queen's University Belfast, University Road, Belfast, BT7 1NN, UK
| | | | - Ibrahim Alam
- University of Aberdeen, Suttie Centre, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Aamna Ali
- School of Medicine, University of Leeds, Worsley Building, Leeds, LS2 9NL, UK
| | - Richard Anderson
- School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 0SP, UK
| | - Jia Jun Ang
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Fady Sameh Anis
- The University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Sonam Aojula
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Catherine Arthur
- Brighton and Sussex Medical School, BSMS Teaching Building, University of Sussex, Brighton, BN1 9PX, UK
| | - Alena Ashby
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE, UK
| | - Ahmed Ashraf
- University of Aberdeen, Suttie Centre, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Emma Aspinall
- Whiston Hospital, Warrington Road, Prescot, L35 5DR, UK
| | - Mark Awad
- Faculty of Health Sciences, University of Bristol Medical School, First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH, UK
| | | | - Shreya Badhrinarayanan
- Brighton and Sussex Medical School, BSMS Teaching Building, University of Sussex, Brighton, BN1 9PX, UK
| | - Soham Bandyopadhyay
- Medical Sciences Divisional Office, University of Oxford, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| | - Sam Barnes
- University of Leicester School of Medicine, George Davies Centre, Lancaster Road, Leicester, LE1 7HA, UK
| | - Daisy Bassey-Duke
- Faculty of Health Sciences, University of Bristol Medical School, First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH, UK
| | - Charlotte Boreham
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Rebecca Braine
- Medical Sciences Divisional Office, University of Oxford, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| | - Joseph Brandreth
- The University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Zoe Carrington
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE, UK
| | - Zoe Cashin
- Brighton and Sussex Medical School, BSMS Teaching Building, University of Sussex, Brighton, BN1 9PX, UK
| | - Shaunak Chatterjee
- Birmingham Medical School, Vincent Drive, Edgbaston B15 2TT, Birmingham, West Midlands, UK
| | - Mehar Chawla
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK
| | - Chung Shen Chean
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE, UK
| | - Chris Clements
- St James's University Hospital, Beckett Street, Leeds, West Yorkshire, LS9 7TF, UK
| | - Richard Clough
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Jessica Coulthurst
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE, UK
| | - Liam Curry
- University of Leicester School of Medicine, George Davies Centre, Lancaster Road, Leicester, LE1 7HA, UK
| | - Vinnie Christine Daniels
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Simon Davies
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Rebecca Davis
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE, UK
| | - Hanelie De Waal
- Brighton and Sussex Medical School, BSMS Teaching Building, University of Sussex, Brighton, BN1 9PX, UK
| | - Nasreen Desai
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE, UK
| | - Hannah Douglas
- University of Edinburgh Medical School, 47 Little France Cres, Edinburgh, EH16 4TJ, UK
| | - James Druce
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | | | - Meron Esere
- Medical Sciences Divisional Office, University of Oxford, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| | - Alex Eyre
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Ibrahim Talal Fazmin
- School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 0SP, UK
| | - Sophia Fitzgerald-Smith
- Faculty of Health Sciences, University of Bristol Medical School, First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH, UK
| | - Verity Ford
- Faculty of Medicine, University of Southampton, Building 85, Life Sciences Building, Highfield Campus, Southampton, SO17 1BJ, UK
| | - Sarah Freeston
- Homerton University Hospital, Homerton Row E9 6SR, London, UK
| | | | - Whitney General
- Faculty of Health Sciences, University of Bristol Medical School, First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH, UK
| | - Helen Gilbert
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Zein Gowie
- Faculty of Medicine, University of Southampton, Building 85, Life Sciences Building, Highfield Campus, Southampton, SO17 1BJ, UK
| | - Ciaran Grafton-Clarke
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE, UK
| | - Keshni Gudka
- The University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Leher Gumber
- Brighton and Sussex Medical School, BSMS Teaching Building, University of Sussex, Brighton, BN1 9PX, UK
| | - Rishi Gupta
- UCL Medical School, 74 Huntley Street, London, WC1E 6BT, UK
| | - Chris Harlow
- St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - Amy Harrington
- Faculty of Medicine, University of Southampton, Building 85, Life Sciences Building, Highfield Campus, Southampton, SO17 1BJ, UK
| | - Adele Heaney
- Queen's University Belfast, University Road, Belfast, BT7 1NN, UK
| | - Wing Hang Serene Ho
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE, UK
| | - Lucy Holloway
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Christina Hood
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Eleanor Houghton
- The University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Saba Houshangi
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK
| | - Emma Howard
- School of Medicine, Keele University, David Weatherall Building, Keele University Campus, Staffordshire, ST5 5BG, UK
| | - Benjamin Human
- School of Medicine, University of Leeds, Worsley Building, Leeds, LS2 9NL, UK
| | - Harriet Hunter
- School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 0SP, UK
| | - Ifrah Hussain
- Imperial College School of Medicine, South Kensington Campus, London, SW7 2AZ, UK
| | - Sami Hussain
- UCL Medical School, 74 Huntley Street, London, WC1E 6BT, UK
| | | | | | - Ryan Janjuha
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK
| | - Saleh Jawad
- Faculty of Medicine, University of Southampton, Building 85, Life Sciences Building, Highfield Campus, Southampton, SO17 1BJ, UK
| | - Muzzamil Jelani
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - David Johnston
- School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 0SP, UK
| | - Mike Jones
- University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, LE1 5WW, UK
| | - Sadhana Kalidindi
- Faculty of Health Sciences, University of Bristol Medical School, First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH, UK
| | - Savraj Kalsi
- University of York, John Hughlings Jackson Building, Heslington, York, YO10 5DD, UK
| | - Asanish Kalyanasundaram
- School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 0SP, UK
| | - Anna Kane
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Sahaj Kaur
- School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 0SP, UK
| | | | - Qaisar Khan
- University of Aberdeen, Suttie Centre, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Sajan Khullar
- School of Medicine, Keele University, David Weatherall Building, Keele University Campus, Staffordshire, ST5 5BG, UK
| | - Priscilla Kirkland
- University of Edinburgh Medical School, 47 Little France Cres, Edinburgh, EH16 4TJ, UK
| | - Hannah Lawrence-Smith
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE, UK
| | - Charlotte Leeson
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK
| | | | - Kerry Long
- Nottingham University Hospitals NHS Trust, Hucknall Rd, Nottingham, NG5 1PB, UK
| | - Simon Lubbock
- The University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | | | - Rachel Maguire
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Praveen Mahendran
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE, UK
| | - Saad Majeed
- University of Aberdeen, Suttie Centre, Foresterhill, Aberdeen, AB25 2ZD, UK
| | | | - Vinay Mandagere
- Faculty of Health Sciences, University of Bristol Medical School, First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH, UK
| | - Angelos Mantelakis
- St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - Sophie McGovern
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Anjola Mosuro
- Faculty of Health Sciences, University of Bristol Medical School, First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH, UK
| | - Adam Moxley
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Sophie Mustoe
- Guy's, King's and St Thomas' School of Medical Education, Henriette Raphael Building, Guy's Campus, London, SE1 1UL, UK
| | - Sam Myers
- UCL Medical School, 74 Huntley Street, London, WC1E 6BT, UK
| | - Kiran Nadeem
- Manchester Medical School, Stopford Building, Oxford Rd, Manchester, M13 9PT, UK
| | - Reza Nasseri
- Faculty of Health Sciences, University of Bristol Medical School, First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH, UK
| | - Tom Newman
- School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 0SP, UK
| | - Richard Nzewi
- University of Leicester School of Medicine, George Davies Centre, Lancaster Road, Leicester, LE1 7HA, UK
| | - Rosalie Ogborne
- St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - Joyce Omatseye
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE, UK
| | - Sophie Paddock
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK
| | - James Parkin
- St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - Mohit Patel
- University of York, John Hughlings Jackson Building, Heslington, York, YO10 5DD, UK
| | - Sohini Pawar
- School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 0SP, UK
| | - Stuart Pearce
- St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - Samuel Penrice
- University of Dundee School of Medicine, 4 Kirsty Semple Way, Dundee, DD2 4BF, UK
| | - Julian Purdy
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Raisa Ramjan
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK
| | - Ratan Randhawa
- UCL Medical School, 74 Huntley Street, London, WC1E 6BT, UK
| | - Usman Rasul
- University of Aberdeen, Suttie Centre, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Elliot Raymond-Taggert
- Faculty of Health Sciences, University of Bristol Medical School, First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH, UK
| | - Rebecca Razey
- Imperial College School of Medicine, South Kensington Campus, London, SW7 2AZ, UK
| | - Carmel Razzaghi
- Queen's University Belfast, University Road, Belfast, BT7 1NN, UK
| | - Eimear Reel
- Queen's University Belfast, University Road, Belfast, BT7 1NN, UK
| | - Elliot John Revell
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Joanna Rigbye
- University of Edinburgh Medical School, 47 Little France Cres, Edinburgh, EH16 4TJ, UK
| | | | - Abdelrahman Said
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK
| | - Emma Sanders
- Faculty of Health Sciences, University of Bristol Medical School, First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH, UK
| | - Pranoy Sangal
- University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, LE1 5WW, UK
| | - Nora Sangvik Grandal
- University of York, John Hughlings Jackson Building, Heslington, York, YO10 5DD, UK
| | - Aadam Shah
- University of Aberdeen, Suttie Centre, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Rahul Atul Shah
- School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 0SP, UK
| | - Oliver Shotton
- Medical Sciences Divisional Office, University of Oxford, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| | - Daniel Sims
- Brighton and Sussex Medical School, BSMS Teaching Building, University of Sussex, Brighton, BN1 9PX, UK
| | - Katie Smart
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK
| | - Martha Amy Smith
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Nick Smith
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK
| | - Aninditya Salma Sopian
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Matthew South
- The University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Jessica Speller
- University of Leicester School of Medicine, George Davies Centre, Lancaster Road, Leicester, LE1 7HA, UK
| | - Tom J Syer
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK
| | - Ngan Hong Ta
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK
| | - Daniel Tadross
- School of Medicine, University of Leeds, Worsley Building, Leeds, LS2 9NL, UK
| | - Benjamin Thompson
- University of York, John Hughlings Jackson Building, Heslington, York, YO10 5DD, UK
| | - Jess Trevett
- University of York, John Hughlings Jackson Building, Heslington, York, YO10 5DD, UK
| | - Matthew Tyler
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Roshan Ullah
- Birmingham Medical School, Vincent Drive, Edgbaston B15 2TT, Birmingham, West Midlands, UK
| | - Mrudula Utukuri
- School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 0SP, UK
| | - Shree Vadera
- UCL Medical School, 74 Huntley Street, London, WC1E 6BT, UK
| | | | - Sara Venturini
- Aberdeen Royal Infirmary, Foresterhill, Aberdeen, AB25 2ZN, UK
| | - Aradhya Vijayakumar
- University of Leicester School of Medicine, George Davies Centre, Lancaster Road, Leicester, LE1 7HA, UK
| | - Melanie Vine
- University of Leicester School of Medicine, George Davies Centre, Lancaster Road, Leicester, LE1 7HA, UK
| | - Zoe Wellbelove
- University of York, John Hughlings Jackson Building, Heslington, York, YO10 5DD, UK
| | - Liora Wittner
- UCL Medical School, 74 Huntley Street, London, WC1E 6BT, UK
| | - Geoffrey Hong Kiat Yong
- Medical Student Office, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Farris Ziyada
- Guy's, King's and St Thomas' School of Medical Education, Henriette Raphael Building, Guy's Campus, London, SE1 1UL, UK
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Affiliation(s)
- Sadhana Kalidindi
- University of Bristol Medical School, Bristol, United Kingdom (S.K.)
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Mallas E, Carletti F, Chaddock CA, Shergill S, Woolley J, Picchioni MM, McDonald C, Toulopoulou T, Kravariti E, Kalidindi S, Bramon E, Murray R, Barker GJ, Prata DP. The impact of CACNA1C gene, and its epistasis with ZNF804A, on white matter microstructure in health, schizophrenia and bipolar disorder1. Genes, Brain and Behavior 2016; 16:479-488. [DOI: 10.1111/gbb.12355] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 10/24/2016] [Accepted: 10/25/2016] [Indexed: 12/16/2022]
Affiliation(s)
- E. Mallas
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience; King's College London
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Department of Medicine; Imperial College London; London
| | - F. Carletti
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience; King's College London
- Department of Neuroradiology, John Radcliffe Hospital; Oxford University Hospitals NHS Trust; Oxford
| | - C. A. Chaddock
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience; King's College London
| | - S. Shergill
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience; King's College London
| | - J. Woolley
- Psychological Medicine; Royal Brompton & Harefield NHS Trust; London
| | - M. M. Picchioni
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience; King's College London
- St. Andrew's Academic Department; St Andrew's Healthcare; Northampton UK
| | - C. McDonald
- Neuroimaging, Cognition & Genomics Centre (NICOG) & NCBES Galway Neuroscience Centre, College of Medicine, Nursing and Health Sciences; National University of Ireland Galway; Galway Ireland
| | - T. Toulopoulou
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience; King's College London
- Department of Psychology; The University of Hong Kong; Hong Kong Special Administrative Region
| | - E. Kravariti
- Department of Psychology, Institute of Psychiatry; Psychology & Neuroscience King's College London
| | - S. Kalidindi
- Department of Psychology, Institute of Psychiatry; Psychology & Neuroscience King's College London
| | - E. Bramon
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience; King's College London
- Mental Health Neurosciences Research Department, Division of Psychiatry; University College London
| | - R. Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience; King's College London
| | - G. J. Barker
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience; King's College London; London UK
| | - D. P. Prata
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience; King's College London; London UK
- Instituto de Medicina Molecular; Faculdade de Medicina da Universidade de Lisboa; Lisbon Portugal
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7
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Adler O, Kalidindi S, Butt A, Hussain KMA. Chordae Tendineae Rupture Resulting in Pulmonary Edema in a Patient with Discrete subvalvular Aortic Stenosis. Angiology 2016; 54:613-7. [PMID: 14565639 DOI: 10.1177/000331970305400513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This report concerns an apparently healthy elderly woman who presented with gradually worsening mitral regurgitation secondary to chordae tendineae rupture leading to pulmonary edema in the presence of discrete subvalvular aortic stenosis with a severe gradient reflecting the left ventricular outflow tract obstruction. The gradual worsening of heart failure took place parallel to the increase in severity of mitral regurgitation in a short period. The patient underwent successful mitral valve replacement with myectomy. Surgical inspection revealed rupture of the chordae tendineae to the posterior leaflets without any significant primary intrinsic disease of the mitral valve. The predominant mechanism of chordae tendineae rupture in this patient with discrete subvalvular aortic stenosis is a severe pressure gradient. It is suggested that increased awareness of chordae tendineae rupture as a cause of mitral regur gitation and the prompt use of appropriate diagnostic tools may facilitate the timely recogni tion of this potentially fatal, but treatable, cause of mitral regurgitation in patients with left ventricular outflow tract obstruction.
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Affiliation(s)
- O Adler
- Division of Cardiology, Department of Medicine, Conemaugh Memorial Medical Center, Johnstown, PA, USA
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8
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Picchioni M, Toulopoulou T, Rijsdijk F, McDonald C, Kane F, Kalidindi S, Murray R, McGuire P. Genetic and Environmental Influences On Brain Function in Schizophrenia. an FMRI Study of the Maudsley Twin and Family Cohorts. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)31336-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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9
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Huq S, Price D, Sureshkumar S, Kalidindi S, Walshaw M, Hadcroft J. P28 The impact of patient information leaflets in sleep clinic. Thorax 2011. [DOI: 10.1136/thoraxjnl-2011-201054c.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Huq S, Sureshkumar S, Kalidindi S, Haris M, Greenwood J, Ledson M. 348 How well are cystic fibrosis patients coping in the real world? A snapshot of socioeconomic, education and home circumstances. J Cyst Fibros 2011. [DOI: 10.1016/s1569-1993(11)60360-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Huq S, Kalidindi S, Sureshkumar S, Chandramouli S, Greenwood J, Walshaw M. 325 What role do the general practitioners (GP) have in the care of cystic fibrosis (CF) patients? J Cyst Fibros 2011. [DOI: 10.1016/s1569-1993(11)60338-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Prata DP, Mechelli A, Picchioni M, Fu CHY, Kane F, Kalidindi S, McDonald C, Kravariti E, Toulopoulou T, Bramon E, Walshe M, Murray R, Collier DA, McGuire PK. No association of Disrupted-in-Schizophrenia-1 variation with prefrontal function in patients with schizophrenia and bipolar disorder. Genes Brain Behav 2010; 10:276-85. [PMID: 21091867 DOI: 10.1111/j.1601-183x.2010.00665.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The Disrupted-in-Schizophrenia-1 (DISC1) gene has been implicated in both schizophrenia and bipolar disorder by linkage and genetic association studies. Altered prefrontal cortical function is a pathophysiological feature of both disorders, and we have recently shown that variation in DISC1 modulates prefrontal activation in healthy volunteers. Our goal was to examine the influence of the DISC1 polymorphism Cys704Ser on prefrontal function in schizophrenia and bipolar disorder. From 2004 to 2008, patients with schizophrenia (N = 44), patients with bipolar disorder (N = 35) and healthy volunteers (N = 53) were studied using functional magnetic resonance imaging while performing a verbal fluency task. The effect of Cys704Ser on cortical activation was compared between groups as Cys704 carriers vs. Ser704 homozygotes. In contrast to the significant effect on prefrontal activation we had previously found in healthy subjects, no significant effect of Cys704Ser was detected in this or any other region in either the schizophrenia or bipolar groups. When controls were compared with patients with schizophrenia, there was a diagnosis by genotype interaction in the left middle/superior frontal gyrus [family-wise error (FWE) P = 0.002]. In this region, Ser704/ser704 controls activated more than Cys704 carriers, and there was a trend in the opposite direction in schizophrenia patients. In contrast to its effect in healthy subjects, variation in DISC1 Cys704Ser704 genotype was not associated with altered prefrontal activation in patients with schizophrenia or bipolar disorder. The absence of an effect in patients may reflect interactions of the effects of DISC1 genotype with the effects of other genes associated with these disorders, and/or with the effects of the disorders on brain function.
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Affiliation(s)
- D P Prata
- Division of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, UK.
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Papagni S, Mechelli A, Prata D, Kambeitz J, Picchioni M, Fu C, Kane F, Kalidindi S, McDonald C, Kravariti E, Toulopoulou T, Murray R, Collier D, McGuire P. PW01-153 - Effect of DAAO on regional brain function in healthy individuals and patients with schizophrenia and bipolar disorder. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)71552-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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14
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Hall MH, Schulze K, Rijsdijk F, Kalidindi S, McDonald C, Bramon E, Murray RM, Sham P. Are auditory P300 and duration MMN heritable and putative endophenotypes of psychotic bipolar disorder? A Maudsley Bipolar Twin and Family Study. Psychol Med 2009; 39:1277-1287. [PMID: 19250581 DOI: 10.1017/s0033291709005261] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Impaired P300 auditory response has been reported in patients with psychotic bipolar disorder (BPD) and unaffected relatives of psychotic bipolar patients. Deficits in mismatch negativity (MMN), however, have not been observed in bipolar patients. To our knowledge, no family study of MMN in BPD has been reported. The current study combined the Maudsley twin and bipolar family samples using genetic model fitting analyses to: (1) assess the relationship between BPD and MMN, (2) substantiate the association between psychotic BPD and P300 variables, (3) verify the genetic overlap of BPD with P300 amplitude previously reported in the twin sample, and (4) examine the shared genetic influences between BPD and bilateral temporal scalp locations of P300 components. METHOD A total of 301 subjects were included in this study, including 94 twin pairs, 31 bipolar families, and 39 unrelated healthy controls. Statistical analyses were based on structural equation modelling. RESULTS Both P300 and MMN are heritable, with heritability estimates of 0.58 for MMN, 0.68-0.80 for P300 amplitude, and 0.21-0.56 for P300 latency. The bipolar patients and their relatives showed normal MMN. No significant association, either genetic or environmental, was found with BPD. BPD was significantly associated with reduced P300 amplitude and prolonged latency on midline and bilateral temporal-posterior scalp areas. Shared genetic factors were the main source of these associations. CONCLUSIONS The results confirm that MMN is not an endophenotype for psychotic BPD whereas P300 amplitude and latency components are valid endophenotypes for psychotic BPD.
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MESH Headings
- Acoustic Stimulation
- Adult
- Bipolar Disorder/diagnosis
- Bipolar Disorder/genetics
- Bipolar Disorder/physiopathology
- Bipolar Disorder/psychology
- Cerebral Cortex/physiopathology
- Cohort Studies
- Contingent Negative Variation/genetics
- Diseases in Twins/diagnosis
- Diseases in Twins/genetics
- Diseases in Twins/physiopathology
- Diseases in Twins/psychology
- Dominance, Cerebral/genetics
- Dominance, Cerebral/physiology
- Electrocardiography
- England
- Event-Related Potentials, P300/genetics
- Event-Related Potentials, P300/physiology
- Evoked Potentials, Auditory/genetics
- Evoked Potentials, Auditory/physiology
- Female
- Humans
- Male
- Middle Aged
- Models, Genetic
- Phenotype
- Psychiatric Status Rating Scales
- Reaction Time/genetics
- Reaction Time/physiology
- Signal Processing, Computer-Assisted
- Social Environment
- Statistics as Topic
- Twins, Dizygotic/genetics
- Twins, Dizygotic/psychology
- Twins, Monozygotic/genetics
- Twins, Monozygotic/psychology
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Affiliation(s)
- M-H Hall
- Psychology Research Laboratory, Harvard Medical School, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA.
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Kane F, Kravariti E, Kalidindi S, Georgiades A, Barker G, Murray R. White Matter Abnomalities in Twins with Bipolar Disorder and their Unaffected Cotwins. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)70095-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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16
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Prata D, Mechelli A, Fu C, Picchioni M, Kane F, Kalidindi S, Mcdonald C, Kravariti E, Toulopoulou T, Saeedzadeh-Sardahaee F, Murray R, Collier D, Mcguire P. Effects of the DAT 3’UTR VNTR Genotype on Brain Function in Healthy Subjects and Patients with Schizophrenia. Eur Psychiatry 2009. [DOI: 10.1016/s0924-9338(09)70932-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Aims:To examine the effect of a polymorphism in the Dopamine Transporter (DAT) gene on brain activation during executive function and, for the first time:1.determine the extent to which this is altered in schizophrenia and2.use a verbal fluency paradigm.This is relevant since:1.DAT plays a key role in the regulation of dopamine, which modulates cortical activation during cognitive tasks and2.a disruption of dopamine function is a fundamental pathophysiological feature of schizophrenia.Method:Functional magnetic resonance imaging was used to measure whole-brain responses during overt verbal fluency in 85 subjects: 44 healthy volunteers and 41 DSM-IV schizophrenia patients. Main effects of genotype and diagnostic group on activation and their interaction were estimated using an ANOVA in SPM5.Results:The 10-repeat allele of the 3'UTR VNTR was associated with greater activation than the 9-repeat allele in the left (Z=4.8; FWEp=0.005) and right (Z=4.2; FWEp=0.057) anterior insula and with decreased activation in the rostral anterior cingulate (Z=4.3 FWEp=0.04) during word generation (versus baseline). These effects were irrespective of diagnostic group but generally more marked in patients. There were also strong trends for groupxgenotype interactions in the left middle frontal gyrus and the left nucleus accumbens. Analysis was controlled for task performance, IQ, antipsychotic medication, psychopathology and demographics.Conclusion:Cortical function during executive tasks is normally modulated by variation in the DAT gene, effect which is dependent on the brain region. DAT's effect may be altered in schizophrenia patients, which may reflect altered central dopamine function.
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Surguladze SA, Elkin A, Ecker C, Kalidindi S, Corsico A, Giampietro V, Lawrence N, Deeley Q, Murphy DGM, Kucharska-Pietura K, Russell TA, McGuffin P, Murray R, Phillips ML. Genetic variation in the serotonin transporter modulates neural system-wide response to fearful faces. Genes Brain Behav 2008; 7:543-51. [PMID: 18266983 DOI: 10.1111/j.1601-183x.2008.00390.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A distributed, serotonergically innervated neural system comprising extrastriate cortex, amygdala and ventral prefrontal cortex is critical for identification of socially relevant emotive stimuli. The extent to which a genetic variation of serotonin transporter gene 5-HTTLPR impacts functional connectivity between the amygdala and the other components of this neural system remains little examined. In our study, neural activity was measured using event-related functional magnetic resonance imaging in 29 right-handed, white Caucasian healthy subjects as they viewed mild or prototypical fearful and neutral facial expressions. 5-HTTLPR genotype was classified as homozygous for the short allele (S/S), homozygous for the long allele (L/L) or heterozygous (S/L). S/S showed greater activity than L/L within right fusiform gyrus (FG) to prototypically fearful faces. To these fearful faces, S/S more than other genotype subgroups showed significantly greater positive functional connectivity between right amygdala and FG and between right FG and right ventrolateral prefrontal cortex (VLPFC). There was a positive association between measure of psychoticism and degree of functional connectivity between right FG and right VLPFC in response to prototypically fearful faces. Our data are the first to show that genotypic variation in 5-HTTLPR modulates both the amplitude within and the functional connectivity between different components of the visual object-processing neural system to emotionally salient stimuli. These effects may underlie the vulnerability to mood and anxiety disorders potentially triggered by socially salient, emotional cues in individuals with the S allele of 5-HTTLPR.
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Affiliation(s)
- S A Surguladze
- Institute of Psychiatry, King's College London, London, United Kingdom.
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Prata DP, Mechelli A, Fu CHY, Picchioni M, Kane F, Kalidindi S, McDonald C, Kravariti E, Toulopoulou T, Miorelli A, Murray R, Collier DA, McGuire PK. Effect of disrupted-in-schizophrenia-1 on pre-frontal cortical function. Mol Psychiatry 2008; 13:915-7, 909. [PMID: 18800054 DOI: 10.1038/mp.2008.76] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Argyropoulos SV, Landau S, Kalidindi S, Toulopoulou T, Castle DJ, Murray RM, Picchioni MM. Twins discordant for schizophrenia: psychopathology of the non-schizophrenic co-twins. Acta Psychiatr Scand 2008; 118:214-9. [PMID: 18498431 DOI: 10.1111/j.1600-0447.2008.01205.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Patients with schizophrenia are more likely to suffer from mood and anxiety disorders compared with the general population. We explored the aetiology of this comorbidity using a twin study design. METHOD We applied an additive genetic + unique environment (AE) random effects model in the analysis of 35 non-schizophrenic co-twins from pairs discordant for schizophrenia, and 131 control twins. RESULTS Non-schizophrenic co-twins had significantly increased rates of depression (P = 0.006) and anxiety disorders (P = 0.021) compared with the control twins. CONCLUSION Our results provide evidence for a familial association between schizophrenia and anxiety and depression. This could reflect common aetiological factors contributing to each of the disorders. Future studies should attempt to investigate the relative genetic and environmental contribution to the shared risk factors for schizophrenia, mood and anxiety disorders.
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Affiliation(s)
- S V Argyropoulos
- Division of General Psychiatry and Psychological Medicine, Institute of Psychiatry, London, UK.
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Abstract
A new swelling copolymeric material suitable for self-anchoring bone implants was introduced in part I of this two-part article. The main goal in the second part of the study was to investigate the in vitro fixation characteristics of these novel implants in bone using push-out mechanical testing. Specifically, we examined the various factors that influence the in vitro fixation levels achieved by these anchors and identified a range of copolymer compositions that provide good fixation characteristics for these implants. The factors studied included the copolymer composition, presence of AS-4 carbon fiber reinforcement, and the time of implantation (in an environment of saline solution). The push-out tests were conducted on smooth cylindrical plugs of the swelling materials that were implanted in bovine cortical bone. The bone-implant system was then immersed in saline solution for various periods of time ranging from 1 to 28 days prior to push-out testing. The refixation characteristics of the implants were also investigated in this study by performing repeated push-out tests on a single implant without completely dislodging the implant from the bone. Holding strengths comparable and often exceeding many current orthopedic fixation techniques were obtained (push-out load exceeding 1000 N and shear strength exceeding 7 MPa) with the implant having 80/20 to 70/30 methyl methacrylate/acrylic acid ratios. Furthermore, more than 80% of the ultimate holding strength could be achieved within 7 days of implantation at ambient temperature for the 80/20 composite implants. Excellent refixation properties were demonstrated in which the implant regained its full holding strength in the bone immediately after an initial failure. These results indicate great potential for the possible use of these implants for orthopedic applications such as suture anchoring and internal fracture fixations.
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Affiliation(s)
- A Vemuganti
- Biomedical Engineering and Science Institute, Drexel University, Philadelphia, Pennsylvania, USA
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