A rare anatomic variation: Triple mental foramina.

Multiple mental foramina (MF) are rarely found in the human mandible. We report on the case, as documented using cone beam computed tomography (CBCT), of the triple MF that were identified on the right hemimandible of a 28-year-old female patient. The distal foramen was located on the mandible between the apices of the second premolar root and the first molar mesiovestibular root, being reached by a thin canal that left the mandibular canal. A pair of mesial foramina were identified between the apices of the premolar teeth. Thus, the three foramina corresponded to a surface area of 23.49mm2 of the mandible. On the opposite side, a single mental foramen had a surface area of just 13.25mm2. On each side, retromolar canals that opened into the retromolar fossae were also found. The anatomic possibility of multiple MF increases the surface area at risk during surgical procedures, increases the risk of neurovascular damage and obscures the common tooth-related location of the mental foramen. Practitioners should, therefore, consider a personalised and imaging-documented approach so as to avoid treatment failure.

Bilateral giant and unilateral duplicated sphenoidal tubercle.

The sphenoidal tubercle (SphT), also known as pyramidal tubercle or infratemporal spine projects from the anterior end of the infratemporal crest of the greater sphenoidal wing. As it masquerades the lateral entrance in the pterygopalatine fossa it could obstruct surgical corridors or the access for anaesthetic punctures. The SphT is, however, an overlooked structure in the anatomical literature. During a routine cone beam computed tomography study in an adult male patient we found bilateral giant SphTs transforming the infratemporal surfaces of the greater wing into veritable pterygoid foveae. Moreover, on one side the SphT appeared bifid, with a main giant partition, of 9.17 mm vertical length, and a secondary laminar one. The opposite SphT had 14.80 mm. In our knowledge, such giant and bifid SphTs were not reported previously and are major obstacles if surgical access towards the pterygopalatine fossa and the skull base is intended.

Factors that Impact Caregivers of Patients with Schizophrenia.

Schizophrenia, a term first introduced by Eugen Bleurer in 1911, is a controversial topic, a symbol of profound behavioral and personality disorders. Although schizophrenia mainly affects the patients, directly, it indirectly affects their caregivers. Because caregivers of subjects with schizophrenia experience significant burden in taking care of the patient, usually over a long period of time, we decided to analyze some of the factors that can impact the perceived level of stress. Our study group consisted of caregivers 124 patients with schizophrenia, interviewed between January 2018 and July 2019. We analyzed demographic, clinical and other medical variables of patients and caregivers. We also evaluated caregivers' burden, using the adapted Zarit interview. The average Zarit score in our study was 42.36±8.64, which shows moderate to high burden. Several factors that influence the perceived burden of the caregiver have been identified, such as patient gender, age of onset, patient and caregiver marital status, patient level of education and social functioning, caregiver age, somatic comorbidities and therapeutic compliance of the patient.

Mental Disorders in Chronic Liver Diseases with Viral Etiology.

The study of chronic viral hepatitis represents a real challenge for modern medicine. If we also analyze this illness from the point of the mental changes involved, the complexity of the study increases. To the etiological, symptomatological polymorphism, alongside the paraclinical and conduct diagnosis, there may be easily added the multitude of mental disorders. The authors have tried, through this paper, to draw the attention upon the importance of studying certain mental disorders connected to a somatic disease, each and every representing a distinct entity, but which together may reach a remarkable complexity.