Distance of the cervical part of the internal carotid artery from the selected anatomical structures in the parapharyngeal space and its relation to patient characteristics.

Anomalies of the internal carotid artery (ICA) can increase the risk of haemorrhage during common surgical procedures. The aim of this literature review was to summarize the current state of knowledge on the course of the internal carotid artery in the parapharyngeal space, including the impact of the patient characteristics on the distances between the artery and other anatomical structures, as well as symptoms accompanying the aberrations. Pathologies related to the course of ICA in the parapharyngeal space are common (10%-60% in the general population and up to 84.4% in the elderly). In women, the distances in the oropharynx area are shorter than in men. Although the number of morphological studies is growing, providing more information on this topic, the identified studies differ in the methods and results. Knowledge on the variability in the course of ICA can help identify patients at high risk for the ICA trauma during pharyngeal procedures.

Police-suspect interactions and confession rates are affected by suspects' alcohol and drug use status in low-stakes crime interrogations.

Background: Low-stakes crimes related to alcohol and/or drugs are common around the world, but research is lacking on police-suspect interactions of such crimes. A large proportion of these suspects are intoxicated during interrogations, and many may have substance use disorder, making them potentially vulnerable to interrogative pressure. Methods: To address this lack of knowledge, the taxonomy of interrogation methods framework (i.e., 60+ interrogation techniques classified into five domains) and a common classification of question types (appropriate vs. inappropriate) were applied in the coding of written police interrogations. Two archival studies, one pilot (Study 1, N = 39) and one main study (Study 2, N = 97) analyzed police interrogations with suspects of alcohol- and drug-related crimes in Sweden. Results: For both Study 1 and 2, suspects showed signs of alcohol and/or drug intoxication, hangover or withdrawal in more than 50% of all interrogations. In Study 2, additional coding indicated that suspects displayed signs of substance use disorder in 57% of the interrogations. The main results from both studies revealed a large number of direct questions asked by the police across all interrogations, and relatively little use of the strategic interrogation techniques from the taxonomy of interrogation methods framework. In fact, when it came to interrogation techniques, law enforcement used more confrontational techniques in their interactions with intoxicated suspects compared to sober suspects. Furthermore, suspects displaying signs of substance use disorder were significantly more cooperative and prone to confess than suspects without indicators of substance use disorder. Conclusion: As the first novel study on low-stakes crime interrogations related to alcohol and/or drugs, the present study provides useful information about current Swedish interrogation practices and areas for improvement. The study results indicate that suspects displaying signs of intoxication or substance use disorder may be more vulnerable during police interrogations. This may in turn have the potential to inform the development of new interrogation policies. Due to the novelty of this research, more studies are needed, both on a national and international level, to examine interrogations in low-stakes crimes further.

Ocular Manifestations of Behçet's Disease: An Update on Diagnostic Challenges and Disease Management.

Behçet's disease is a systemic vasculitis that affects multiple organs. The most common manifestations are oral and genital ulcerations and recurrent uveitis. Uveitis can be an initial symptom in 10-20% of cases and leads to blindness in 16-25% of patients. The management of this disease is evolving due to the clinical phenotypes recently described in the literature and increasing focus on the detection of subclinical inflammation to enable correct therapeutic decisions. The first line treatment is azathioprine, followed by various immunosuppressive and biological agents as alternatives in severe or refractory cases. This review summarizes scientific articles about the etiology of, diagnostic tools for and treatment of the ocular manifestations of Behçet's disease available in the PubMed database from 1 January 2016 to 1 May 2021. A multidisciplinary approach is necessary to effectively prevent permanent damage and thus improve the life quality of the patients. Therefore, it is crucial to raise awareness of the common clusters of symptoms, use of modern imaging methods, such as ocular computed tomography and fluorescein angiography, and novelty treatment algorithms to enable early diagnosis and appropriate management.

The anatomical relation of the extracranial internal carotid artery in the parapharyngeal space.

BACKGROUND: The proximity of the internal carotid artery to the pharyngeal wall poses a risk of injury during nasopharyngeal surgery. OBJECTIVES: The aim of this study was to assess the distances between the extracranial internal carotid artery (ICA) and the pharyngeal wall. MATERIAL AND METHODS: Measurements were taken on certain levels of the pharynx using computed tomography angiography (angio-CT) scans of 97 patients. One-tailed Student's t-test for independent variables and a comparison of expected values for dependent pairs of observations were applied. RESULTS: The shortest distance between the ICA and the pharyngeal wall was 1.1 mm. The ICA is closer to the pharyngeal wall at the epiglottis apex level (16.46 ±0.89 mm) than to the Eustachian tube (ET) (19.8 ±0.62 mm) (p < 0.0005). In women, the ICA is closer to the ET (19.44 ±0.78 mm) than in men (20.17 ±0.96 mm) (p = 0.04). In women, the right ICA is closer to the pharyngeal wall than the left ICA at the level of the lower margin of the 2nd cervical corpus vertebra (C2) (right: 17.6 ±1.8 mm; left: 20.7 ±1.7 mm) (p = 0.002) and at the level of the epiglottis apex (right: 15.2 ±1.7 mm; left: 17.4 ±1.4 mm) (p = 0.028). The bifurcation of the common carotid artery (CCA) is higher in men (19.48 ±2.19 mm below the C2) than in women (21.82 ±1.02 mm) (p < 0.001). When the bifurcation is at the level of the epiglottis apex, the ICA is closer to the pharyngeal wall (12.3 ±1.69 mm) than in other cases (16.46 ±0.89 mm) (p = 0.005). In men, the higher the bifurcation is, the closer the ICA is to the pharyngeal wall at the level of the lower margin of the C2 (p = 0.003). CONCLUSIONS: The risk of ICA incision during surgery differs between the pharyngeal levels, genders and sides of the neck. The ICA may be much closer to the pharyngeal wall than described in the literature.