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Carphology by A Fo Ben

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Lazarus in the news

When a research article is heavily featured in the press we can learn a lot about how to spin a story. Whereas headlines may lead with ‘Paralysed man walks’ or ‘Schnoz stem cells soothe severed spine’—academic credibility and sober peer review yielded ‘Functional regeneration of supraspinal connections in a patient with transected spinal cord following transplantation of bulbar olfactory ensheathing cells with peripheral nerve bridging.’ We wait with bated breath to hear how this breakthrough changes rehabilitation medicine.

Cell Transplant 2014. [Epub ahead of print].

Croc of gold

Bill Bryson insists that Australia is the most dangerous place on Earth primarily for its indigenous beasties and the formidable environment. Is this why Aussies have a relationship with gambling that a Brit may baulk at; gambling in pubs, inside sports grounds and ‘pokies’ (slot machines) on every high-street? Only in Queensland could a researcher ask, ‘What would happen to problem gamblers’ betting styles after they held a metre long saltwater crocodile? (They probably had a little flutter on the outcome). The answer? Problem gamblers were more cautious, but occasional gamblers were more reckless.

J Gambl Stud 2010;26:571–81.

Heart of Darkness

A case control study of sudden cardiac death in primary care from The Netherlands (926 cases, 9832 controls) identified 14 people with epilepsy and cardiac death. The adjusted OR 2.8 (95% CI 1.4 to 5.3) increased for active epilepsy and was reduced in well-treated epilepsy. There was a threefold increase in the risk of sudden cardiac death in those taking sodium-channel blocking anti-epileptic drugs—whether the individual had epilepsy or not. Controversially the authors argue that these are not SUDEPs (sudden unexpected deaths in epilepsy) because the cardiac events did not occur following a recognised seizure.

Heart 2014. doi: 10.1136/heartjnl-2014-305664.

CSI Leicester

Prognostication following traumatic brain injury is notoriously problematic, particularly so when the injury occurred in the past, such as August 1485 at the Battle of Bosworth Field. In 2012 a skeleton was exhumed from beneath a car park in Leicester. Archaeological evidence and mitochondrial DNA analysis suggests it may have been King Richard III of England. CT identified 11 perimortem injuries; nine to the skull and two to the body. The two most likely fatal injuries were at the occiput. These are in keeping with an unseated combatant, perhaps on his knees who was either not wearing a helmet—or had it removed forcibly. The authors do not speculate as to whether he was saying “A horse! A horse! My kingdom for a horse!”

Lancet 2014. pii: S0140-6736(14)60804-7.

One swallow does not make a summer

Pathologists love food comparisons. In contrast, neuroradiologists see animals everywhere—tigers, pandas, humming birds, blob fish. Here, like the dog that did not bark in the night, is the absence of the swallow's tail (figure 1). Researchers studying the shape of the substantia nigra (the nigrosome-1) demonstrated that the characteristic pattern is lost in Parkinson's disease. This had a sensitivity of 100%, a specificity of 95%, and an accuracy of 96% (91% when non-diagnostic scans were included).

PLoS One 2014;9:e93814.

Figure 1

Left: the red rumped swallow (Cecropis daurica) with focus on the tail. Above: A, 3T-susceptibility-weighted (SWI) MR, B: 3D-T2*/SWI MRI (Philips ‘PRESTO’ sequence). The PD patient left, control right. The white arrows point to the ‘swallow's tail.’

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