Topography of the mandibular canal in male human skulls originating from different time periods.

BACKGROUND: Dynamic advances in dentistry, especially in implantology has inspired researchers to carry out many studies investigating the topography of the mandibular canal and its ethnic differences. The aim of the study was a comparative analysis of variations in the position and topography of the mandibular canal based on radiographic images of human mandibles originating from modern and medieval skulls. MATERIALS AND METHODS: Morphometric examination of 126 radiographs of skulls (92 modern and 34 medieval skulls) was included. The age and sex of individuals were determined based on the morphology of the skull, the obliteration of cranial sutures, and the degree of tooth wear. To define the topography of the mandibular canal on X-ray images, we took 8 anthropometric measurements. RESULTS: We observed significant differences in several parameters. The distance between the base of the mandible and the bottom of the mandibular canal, the distance between the top of the mandibular canal and the crest of the alveolar arch, and the height of the mandibular body. Significant asymmetry was found for two parameters of mandibles from modern skulls: the distance between the top of the mandibular canal and the crest of the alveolar arch at the level of the second molar (p < 0.05), and the distance between the mandibular foramen and the margin of the anterior mandibular ramus (p < 0.007). There were no significant differences between measurements taken on the right and left sides of the medieval skulls. CONCLUSIONS: Our study revealed differences in the position of the mandibular canal between modern and medieval skulls, confirming the presence of geographical and chronological differences between populations. Knowledge of variability in the position of the mandibular canal between different local populations is fundamental for the correct interpretation of findings from diagnostic radiological studies used in dental practice and in forensic odontology or analysis of archaeological bone materials.

Selected structures of middle ear relevant to cochlear implantation on the basis of computer tomography.

BACKGROUND: The primary objective of this study was to analyze middle ear structures critical for cochlear implantation using computed tomography. MATERIALS AND METHODS: Patients who underwent cochlear implantation at the Department of Otolaryngology in Szczecin between 2015 and 2022 were eligible for the study. We analyzed computed tomography images of 57 ears in 52 patients. The following parameters were assessed: mastoid aeration, tegmen tympani height, sigmoid sinus position, posterior tympanotomy width, the distance between the facial nerve and chorda tympani, modified facial recess distance, and the prediction line described by other authors. RESULTS: In 69% of patients, after the removal of the round window bony overhang, the round window membrane became fully visible. There were no statistically significant correlations found for parameters describing mastoid process anatomy or those rating the width of the posterior tympanotomy concerning round window access. The prediction lines, according to Kashio and Jwair, were found to be relevant. In cases where patients' access to the niche and membrane of the window was rated as good or very good during clinical evaluation, they were more likely to describe the window as being located posteriorly or medially in the radiological evaluation. Using a binary Jwair scale provided a better correlation with the clinical assessment. In cases where the windows were graded as posterior, the clinical assessment indicated better surgical access, especially to the RWM (Round Window Membrane). CONCLUSIONS: Evaluating middle ear anatomy on a computed tomography scan is useful for preparing for middle ear surgery but does not significantly affect the ability to access the round window. For such access, the position of the window in relation to the facial nerve is the most relevant factor, and measurements based on this relationship hold the highest clinical value.

Balance Disorders in People with History of COVID-19 in Light of Posturographic Tests.

Coronavirus disease-19 (COVID-19), resulting from infection with the SARS-CoV-2 virus, causes not only flu-like symptoms, such as fever, aches, or a dry cough, but also affects the sensory system, leading to a loss of smell and taste or to neurological deficits in the shape of balance disorders and dizziness. PURPOSE OF THE STUDY: Our research aimed to assess the prevalence of balance disorders in patients who had suffered COVID-19. MATERIAL AND METHODS: The study group consisted of 73 subjects with a history of SARS-CoV-2 infection. The control group consisted of 50 healthy people with similar demographics. A balance analysis was performed on a tensometric platform, using the Romberg test. RESULTS: Statistically significant differences between the results of the study group and the control group were obtained in the evaluation of the length of body sways and the area of gravity center, both with open and closed eyes, and in the case of maximum body sways with open eyes. CONCLUSIONS: Patients who have suffered COVID-19 may suffer from balance disorders detectable by posturographic tests.

Postural assessment with the moiré technique in dialyzed patients.

Chronic kidney disease (CKD) patients have limited mobility. A disease that lasts for many years may harm the musculoskeletal system. Knowledge about changes in body posture in these patients is essential in preventing its degradation. In this work, we wanted to draw attention to the changes in the spatial arrangement of the spine and the entire torso in dialysis patients. The study group consisted of 22 female and 32 male dialysis patients. The posture was examined using the moiré projection technique with a portable Computer-Aided System for Posture Assessment which calculated 82 angular and linear parameters of the spine, scapulae, and pelvis in the frontal and sagittal planes. A significant sexual dimorphism was observed for each spine segment. Asymmetry of the scapulae and pelvis was observed in both sexes. Abnormalities may help to establish an accurate exercise plan for dialysis patients. Proper stimulation of the locomotor system can prevent further degradation of body posture.

Sleep-Disordered Breathing in Pregnancy.

Sleep-disordered breathing (SDB) is a spectrum of abnormal respiratory events including habitual snoring and increased upper airway resistance and obstructive episodes. The uncertainties concerning the incidence and recognition of SDB during pregnancy and the importance of the issue for fetal and maternal health prompted us to screen pregnant women for SDB. The study included 312 women in the third trimester of pregnancy aged 17-46 of whom 51 were preselected, based on the results of SDB questionnaires, for a nighttime home screening using a portable ApneaLink Air device. We found that single or multiple episodes of apnea were present in 35 (69%) women. The mean apnea/hypopnea index (AHI) was 1.8 ± 1.8 episodes/h of sleep, which did not exceed the prevalence in the general young-adult female population. However, we noticed a substantial number of inspiratory airflow limitation (IFL) episodes most often accompanied by snoring and more frequent in pregnant women with a greater weight gain. IFLs, although not fulfilling the quantifiable criteria of hypopnea, raise the possibility of hardly recognizable oxygenation and cardiovascular disturbances in pregnancy, reflected in an increased risk index for SDB. We conclude that pregnancy encompasses the risk of revealing or intensifying pre-existing SDB which can jeopardize maternal and fetal health. The risk particularly applies to overweight women. We submit that women in late pregnancy should be carefully screened for possible SDB.

Diagnosis of Sleep-Disordered Breathing in the Home Environment.

Polysomnography, a gold standard for the diagnosis of sleep-disordered breathing, is a complex investigation requiring access to the sleep laboratory. Thus, sleep-disordered breathing could be underdiagnosed. The aim of this paper was to investigate the feasibility and effectiveness of self-performed investigation of obstructive sleep apnea (OSA) in the home setting, using a portable device, and to assess the comfort and simplicity of the procedure from the patient's perspective. The study included 68 middle-aged patients (21 women and 47 men), who were examined at home with the ApneaLink Air device in search for the underlying reason of reported nighttime snoring and occasionally disordered breathing pattern. The apnea-hypopnea index was quantified and matched with body mass index (BMI), age, and other characteristics. OSA was diagnosed in 37 patients (27 men and 10 women): 22 had mild, 4 had moderate, and 11 patients had severe OSA. All cases of severe OSA were present in men. Patients with severe OSA had significantly higher BMI than those from the other groups. All of the patients pointed to the comfort and ease of the diagnostic device. We conclude that home diagnosis of OSA is a relatively easy and cost-effective way to substitute for the hospital-linked polysomnography, particularly in severely ill patients who have a movement difficulty. A wider implementation of home-based diagnosis of OSA may substantially increase the number of patients investigated in a short time span, also leading to the plausibly upward correction of the disease prevalence.

Evaluation of Nocturnal Respiratory Complaints in Pregnant Women.

Snoring during pregnancy increases the risk of low Apgar score and low birth weight of newborns. Snoring women are twice as likely to be diagnosed as having preeclampsia when compared to non-snoring ones. Snoring may also be linked to, albeit it is not a prerequisite for, apneic events at sleep. The aim of this survey-type study was to evaluate the occurrence and severity of nocturnal respiratory complaints in a group of 312 pregnant women. Problems associated with snoring and other nasopharyngeal symptoms were reported by 60% of women. Complaints were more frequent in patients with a higher body mass index. The symptoms were significantly more frequent in the group of snorers. The results of this study suggest a pattern of basic features in pregnancy, such as snoring, overweight, and upper airway symptoms, which all ought to direct attention of care givers to the diagnostics of sleep-related breathing disorders. The early diagnosis would enable to undertake the measures to prevent preterm labor and to avoid postpartum complications in both mother and newborn.

Adenoid Cystic Carcinoma of the Cavernous Sinus - Otolaryngological Sequelae of Therapy: Case Report.

A 60-year-old woman, otherwise in a good health condition, was first admitted to the hospital with a year-long tingling sensations of the right half of the face, which gradually turned into severe neuralgia corresponding to maxillary (V2) and mandibular (V3) branches of the right trigeminal nerve. MRI scans of the head revealed an unusual hyperplastic or inflammatory changes along the brain base, cavernous sinus extending toward the pterygopalatine fossa, and lateral pterygoid on the right side. Meningioma was suspected and neuralgia was treated conservatively. About 2 years later, due to severe facial and eye pain, the patient underwent decompression of trigeminal nerve roots - Janetta's surgery. The following MRI scans revealed a tumor of cavernous sinus, arousing suspicion of malignancy. Histological specimens obtained after a biopsy and then partial transnasal tumor resection yielded a diagnosis of adenoid cystic carcinoma. The patient was treated with proton radiation therapy. The therapy caused burns in the oropharyngeal soft tissues extending from the oral cavity to the throat and esophagus. The additional adverse effect of the therapy was hypoacusis and a damage to the right cornea. A radiation-induced sinusitis appeared that required surgical intervention. The patient suffered a string of further complications, including pneumonia and a transient kidney failure. In the end, the patient survived. The adenoid carcinoma in the currently 64-year-old woman is visibly reduced, but she still suffers from the trigeminal neuralgia. The patient remains under constant laryngological outpatient care as she requires a periodic cleansing of nasal cavities and hypoacusis monitoring.

Influence of physiological stress on the presence of hypoplasia and fluctuating asymmetry in a medieval population from the village of Sypniewo.

This study aims to estimate the levels of physiological stress in the medieval rural population of Sypniewo by evaluating patterns of fluctuating asymmetry (FA) and enamel hypoplasia (EH), and provide information on the influence of physiological stress during the prenatal and perinatal period on early childhood development. Stress is defined as any external or internal condition that challenges homeostasis of an organism. FA is associated with physiological stress occurring mainly during prenatal development and early childhood. The level of FA is thought to reflect the intensity of the stressor(s). EH is caused by physiological stress such as nutritional instability during the first years of life. The studied material consisted of 126 skulls from the village of Sypniewo (Poland). Cranial radiographs were taken in postero-anterior (P-A) and basal views. The images were scanned and calibrated. Measurements of the cranium were used to estimate FA. The presence of EH was assessed using standard anthropological methods The highest levels of FA were observed in the region of the cranial base. EH was observed in 29% of individuals from the rural skeletal series. There was no statistically significant correlation between FA and EH occurrence or between sex and the studied stress indicators.

Concha Bullosa in Paleoanthropological Material.

Concha bullosa is a variant of the sinonasal anatomy in which the middle nasal turbinate contains pneumatized cells, which leads to turbinate enlargement. The reason for concha bullosa formation is unclear, but the variant is seen in up to half the modern population and it may predispose to paranasal sinusitis. The variant has hitherto featured little in paleopathology. Therefore, in the present study we seek to determine the presence of concha bullosa, with the coexisting hypertrophy of the middle turbinate and signs of sinusitis or other pathology of the paranasal complex, in a population living in Tomersdorf-Toporow in the Upper Lausatia, a historical region in Germany and Poland, presently Zgorzelec County in the Lower Silesian voivodeship, at the turn of the nineteenth and twentieth century. The material consisted of 32 skeletons (24 males, 8 females). The gender, age, and stress indicators and the presence of pathological signs were assessed, followed by CT of the skulls. We found 2 skulls (6.3 %) with concha bullosa. In one case septal nasal deviation was present. We conclude that the incidence of concha bullosa could be lower in the past times than at present. Wider research is necessary to settle whether concha bullosa is indeed a rare respiratory paleopathology or a missed, and thus underreported observation.

The impact of auxins used in assisted phytoextraction of metals from the contaminated environment on the alterations caused by lead(II) ions in the organization of model lipid membranes.

Auxins are successfully used to improve phytoextraction efficiency of metal ions from the contaminated environment, however, the mechanism of their activity in this field is not explained. Auxins are known to exert various biochemical alterations in the plant membranes and cells, but their activity involves also direct interactions with lipids leading to changes in membrane organization. Following the suggestion that the auxins-induced modifications in membrane properties alleviate toxic effect of metal ions in this paper we have undertaken the comparative studies on the effect of metal ions and metal ions/auxins mixtures on model membrane systems. The experiments were done on lipid monolayers differing in their composition spread on water subphase and on Pb(2+), Indole-3-acetic acid (IAA), 1-Naphthaleneacetic acid (NAA) and Pb(2+)/IAA and Pb(2+)/NAA water solutions. The analysis of the collected data suggests that metal ions and auxins can change fluidity of the lipid systems and weaken the interactions between monolayer components. This manifested in the increase of the mean area per molecule and the excess area per molecule values for the films on Pb(2+), auxins as well as Pb(2+)/auxin solutions as compared to the values on pure water subphase. However, the presence of auxin in the mixture with lead(II) ions makes the alterations induced by sole metal ions weaker. This effect was more pronounced for the membranes of a higher packing. Thus it was proposed that auxins may enhance phytoextraction of metal ions by weakening their destabilizing effect on membrane.

[Bean Syndrome (blue rubber bleb nevus syndrome)].

The blue rubber bleb nevus syndrome or Bean syndrome is a rare disorder characterised by the presence of haemangiomas in the skin and gastrointestinal tract. These lesions are usually accompanied by chronic hypochromic anaemia resulting from gastrointestinal bleeding. The cause of this syndrome is unknown. It mostly occurs as sporadic, but autosomal dominant inheritance has also been described. The diagnosis is based on endoscopy, magnetic resonance imaging and computer tomography. Treatment is usually symptomatic.

[Evaluation of the dietary habits of polish medical students in their first year of studies]. / Ocena nawyków zywieniowych studentów polskich pierwszego roku medycyny.

INTRODUCTION: One of the most important factors involved in normal growth, maturation, physical activity and mental state is nutrition. Correct patterns formed in youth are necessary to maintain a healthy lifestyle. The aim of the study was the evaluation of the dietary habits of medical students. MATERIAL AND METHODS: The material consisted of data collected from an anonymous survey distributed among first year students of the Faculty of Medicine and Dentistry (66 men and 177 women). The study used a questionnaire of our own design, consisting of open and multi-choice questions concerning the anthropometric data of subjects and nutritional habits. The questionnaire was developed based on the HBSC international standard questionnaire survey on health behaviour in adolescents. Data were analyzed statistically. RESULTS: The prevalence of obesity was generally not observed in the group of examined students. In most cases body mass index was in the range 18.5-24.99%. Obesity was observed only in men. There were no significant differences between the groups of men and women in terms of the frequency of regular meals during the week. Only about 50% of the study population declared regular consumption of the three main meals. Significantly more women than men used slimming diets, and significantly more men took action to control weight. Analysis of the results showed abnormal patterns in the structure of meals. CONCLUSIONS: It is extremely important to educate future doctors in healthy lifestyle, including correct nutrition, through educational programmes during studies.

Rhinitis as a cause of respiratory disorders during pregnancy.

Rhinitis is a common disease of women during pregnancy. It can start in almost any gestational week and disappears after delivery. The main symptoms are sneezing, nasal congestion or running nose. The diagnosis is usually based on history, physical examination, blood tests, and exclusion of the other more common types of rhinitis. The etiology remains to be clarified. The rhinitis may be caused by numerous substances and hormones secreted during pregnancy (PGH, VIP, estrogen, progesterone). They lead to changes in the nasal mucosa in the form of increased activity of serous-mucous glands and increase of their vasculature. The best treatment is using saline irrigations, exercise, and mechanical alar dilators. The nasal decongestants provide only temporary relief. The aim of this study was to evaluate the prevalence of pregnancy rhinitis. The study was conducted on 117 pregnant women in the province of the West Pomerania in 2009-2010. The information was obtained from interviews, questionnaires, and data contained in pregnancy records. About 39% of pregnant women suffered from pregnancy rhinitis. Most such ailments were found during 13th and 21st week of gestation. Doctors should pay more attention to symptoms which result from pregnancy rhinitis, which are reported by their patients. The quality of prenatal care understood as an education of pregnant women as far as pregnancy rhinitis is concerned, is much insufficient. Pregnancy rhinitis significantly affects quality of life of pregnant women and, as a result, it may affect fetal development.

Mental health of Polish students and the occurrence of respiratory tract infections.

The aim of the paper was to examine the association between the psychological status and the occurrence of respiratory tract infections which constitute the most common group of disorders in the student population. The study comprised 500 Polish students aged 19-21. Two psychological scales were utilized: the Goldberg GHQ-12 scale to examine the general psychological status and the CES-D scale to evaluate the symptoms of depression. In addition a pro-health questionnaire in the examined group of students was performed. We found an increased stress level in 51% of students and the symptoms of depression in 22%. An association between distress and the occurrence of respiratory tract infections was found, based on statistical analyses. The highest stress level and related high distress index were observed in the students suffering from lower respiratory tract infections (7.1 scale value). This group self-evaluated their health status as poor, based on the pro-health questionnaire. In the same group of students, lack of sleep (5.4), lack of regular eating habits (4.2) and lack of physical activity (3.9) were also observed. The study shows that the Polish student population is exposed to increased stress level, which, in turn, increases the occurrence of respiratory tract infections.

[Tuberculosis--a neverending story]. / Gruzlica--niekonczaca sie opowiesc.

It is estimated that over one third of the human population is now exposed or has been exposed in the past to Mycobacterium tuberculosis, and new infections occur in the world at a rate of one per second. The history of tuberculosis is long and very interesting, because before the isolation of mycobacteria and the finding of a cure, the disease mercilessly killed thousands of people and deprived doctors of hope. Robert Koch's momentous discovery was a major breakthrough in the fight against tuberculosis. Unfortunately, the disease has never been fully controlled. Tuberculosis is a chronic infectious disease localized in 90-95% of cases in the lungs, and therefore it is extremely difficult to diagnose unequivocally in paleopathological material. Only the form of osteo-arthritis leaves traces in archaeological material. The earliest evidence of tuberculosis (the location of the spine, Pott's disease) in the form of fossils is dated to before 8000 BC. Another very old trace is considered to be human remains from the Neolithic period (ca 5000 BC), found near Heidelberg, where changes in the thoracic spine are typical for spondylitis in tuberculosa. Constant growth in the incidence of new cases in the world can be observed today. Not everyone infected will develop the full-blown disease. The infection may remain dormant. However, one in ten latent infections will subsequently be activated, leading, if not treated, to the death of almost half of the patients.

[Syphilis in the past and present]. / Kila dawniej i dzis.

Syphilis is a specific inflammation which is extremely difficult to clearly diagnose in archaeological material. The origin of this disease is unclear. Most proponents hold the view that it comes from America, and that it was transmitted to Europe by sailors travelling with Columbus. In addition to the thesis of the American origin of syphilis is a suggestion that a mild form of syphilis existed in Europe before Columbus' expeditions. This form, until the end of the fifteenth century, began to spread epidemics. In Poland, the first officially reported case of the disease was described in 1495. Today, an increase in the incidence of new cases in Poland and globally can be observed. An increasing number of cases of congenital syphilis in newborns is also noted. This situation in Poland is connected with a change in the law in 2001, according to which only insured persons became entitled to free treatment. In view of the rising tide of the disease, and the appearance of advanced forms of the disease, in 2009 the free diagnosis, treatment, and follow up for all patients with syphilis was restored.

[Analysis of variation of orbital openings in contemporary skulls]. / Analiza zmiennosci wejscia do oczodolu w czaszkach wspólczesnych.

INTRODUCTION: The size and symmetry of the eye-socket have puzzled many medical and biological scientists. The orbit is a very complicated skull part because of the great number of bones involved in its structure, and its specific physiological function. The aim of our study was to estimate variations in the shape, size and position of the orbital openings in contemporary human skulls by using computer software. MATERIAL AND METHODS: The material consisted of 80 male human skulls of the European population from the beginning of the 20th century. X-ray photographs were taken in the P-A projection, then the images were scanned and calibrated by means of MicroStation 95 Academic Edition software. Tools for measuring the vector elements were used to assess measurements: n-mf, mf-ml, mf-ek, spa--sbk and the area of the orbital opening. The orbital index and the index of morphological asymmetry were assessed. Michalski's tables were used to establish orbit features. The statistical analysis was performed using the Statistica computer software package. RESULTS AND CONCLUSIONS: Measurements of the eye--socket position in relation to the mid-line were significantly more frequently larger on the left-hand side, which means a more lateral position of orbits on that side. The measurements of breadth, height and area were more frequently larger on the right side. The asymmetry index was significant for orbit width. The majority of the examined orbits were classified as hypsikonch, according to the orbital index. According to Michalski's scale, the dominant size data described orbital openings in the European population from the West Pomeranian region. The awareness of variability in this area is necessary for the correct interpretation of patients' examination results, reconstruction planning, in forensic medicine, and anthropology.

[Caries of permanent dentition in medieval inhabitants of Wroclaw]. / Próchnica zebów stalych u sredniowiecznych mieszkanców Wroclawia.

INTRODUCTION: The study of dentition plays an important role in the reconstruction of the diet and in assessment of the overall health and living conditions of paleopopulations. The aim of this study was to determine the condition of permanent dentition of medieval inhabitants of Wroclaw basing on the prevalence and intensity of caries in permanent dentition. MATERIAL AND METHODS: The material consisted of 1156 permanent teeth from 118 skulls recovered from two medieval cemeteries in Wroclaw: the parish cemetery at the St. Elisabeth Church (13th-14th century) and the cemetery in Olbin (12th-13th century). Two age classes were formed taking into account anthropologic assessment and group size. The younger class consisted of material up to the age of 35 years; the remaining skulls were assigned to the older class. The prevalence and incidence of caries was determined. RESULTS: The prevalence and intensity of caries was 56.91% and 15.7%, respectively. Carious lesions predominated in males and in the older age class. CONCLUSIONS: The prevalence and intensity of caries in permanent dentition did not differ from other medieval populations and increased with age. High prevalence of caries reflects a high proportion of carbohydrates in the diet of medieval inhabitants of Wroclaw, their high socioeconomic status, and poor oral hygiene.

Changes of laryngeal parameters during intrauterine life.

OBJECTIVE: Increased care of fetal and neonatal airways has led to advances in neonatal medicine. The early diagnosis and treatment of respiratory diseases require a detailed knowledge of fetal airway anatomy and development. The aim of this study was to determine the anatomical development of the thyroid and cricoid cartilages and their structural variability during fetal life. MATERIAL AND METHODS: The study was performed on the thyroid and cricoid cartilages of 55 human fetal larynges of both sexes, between the ages of 13 and 27 weeks of intrauterine life. Numerous measurements of the thyroid and cricoid cartilages were performed. RESULTS: Correlations between the obtained results were calculated in relation to the crown-rump (C-R) length of human fetuses and to sex. The structural variability of the thyroid and cricoid cartilages of human male and female fetuses in subsequent weeks of intrauterine life was observed. In both genders a correlation between laryngeal size and fetal crown-rump length, regardless of sex, was found. The thyroid cartilage presents a sexual dimorphism. CONCLUSIONS: The results of this study can be useful in the analysis of prenatal examinations, and in planning the treatment of airway emergencies.